Healthcare Provider Details

I. General information

NPI: 1801017462
Provider Name (Legal Business Name): AMY HURLEY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9311 MARSE HENRY DRIVE
LOUISVILLE KY
40299-1176
US

IV. Provider business mailing address

9311 MARSE HENRY WAY
LOUISVILLE KY
40299-1176
US

V. Phone/Fax

Practice location:
  • Phone: 502-303-1383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004641
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: