Healthcare Provider Details

I. General information

NPI: 1609607506
Provider Name (Legal Business Name): SEAN PATRICK HURLBURT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5660 N ADRIAN HWY
ADRIAN MI
49221-8318
US

IV. Provider business mailing address

363 HUNTINGTON DR
SALINE MI
48176-8870
US

V. Phone/Fax

Practice location:
  • Phone: 517-577-0293
  • Fax:
Mailing address:
  • Phone: 847-644-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number5501302971
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: