Healthcare Provider Details

I. General information

NPI: 1447214101
Provider Name (Legal Business Name): GIGI RENEE HURST DC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 N LORRAINE ST
HUTCHINSON KS
67501-5656
US

IV. Provider business mailing address

1627 N LORRAINE ST
HUTCHINSON KS
67501-5656
US

V. Phone/Fax

Practice location:
  • Phone: 620-663-4100
  • Fax: 620-663-4103
Mailing address:
  • Phone: 620-663-4100
  • Fax: 620-663-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4558
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: