Healthcare Provider Details

I. General information

NPI: 1801027271
Provider Name (Legal Business Name): MARK HURLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4931 W 6TH ST STE 116
LAWRENCE KS
66049-4831
US

IV. Provider business mailing address

6117 SW 26TH CT
TOPEKA KS
66614-5224
US

V. Phone/Fax

Practice location:
  • Phone: 785-749-1300
  • Fax: 785-749-4746
Mailing address:
  • Phone: 785-272-1535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1401971
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: