Healthcare Provider Details

I. General information

NPI: 1417997982
Provider Name (Legal Business Name): DEBORAH THOMPSON HURST P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W HOBSONWAY
BLYTHE CA
92225-1421
US

IV. Provider business mailing address

355 N 7TH ST
BLYTHE CA
92225-1826
US

V. Phone/Fax

Practice location:
  • Phone: 760-922-8400
  • Fax: 760-922-8401
Mailing address:
  • Phone: 760-922-8400
  • Fax: 760-922-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT12439
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: