Healthcare Provider Details

I. General information

NPI: 1669519229
Provider Name (Legal Business Name): LORETTA M HULSEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25050 W NEWBERRY RD
NEWBERRY FL
32669-4239
US

IV. Provider business mailing address

27785 W NEWBERRY RD
NEWBERRY FL
32669-4269
US

V. Phone/Fax

Practice location:
  • Phone: 352-472-3555
  • Fax: 352-472-3555
Mailing address:
  • Phone: 352-472-3555
  • Fax: 352-472-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH7019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: