Healthcare Provider Details

I. General information

NPI: 1639407984
Provider Name (Legal Business Name): CHRISTOPHER P HURLEY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2009
Last Update Date: 11/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 RAZORBACK DR SUITE 3
HOUGHTON MI
49931-2830
US

IV. Provider business mailing address

205 OSCEOLA ST
LAURIUM MI
49913-2134
US

V. Phone/Fax

Practice location:
  • Phone: 906-482-8201
  • Fax: 906-482-2771
Mailing address:
  • Phone: 906-337-6591
  • Fax: 906-337-6597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberL1356120
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: