Healthcare Provider Details

I. General information

NPI: 1184507089
Provider Name (Legal Business Name): COLE HARRISON HURST PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 KIRKLAND ST
UNION MS
39365-3205
US

IV. Provider business mailing address

4761 WINSTEAD RD
MERIDIAN MS
39307-9305
US

V. Phone/Fax

Practice location:
  • Phone: 601-774-8233
  • Fax:
Mailing address:
  • Phone: 601-480-9226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7758
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: