Healthcare Provider Details

I. General information

NPI: 1558427658
Provider Name (Legal Business Name): MICHELE LORRAINE HURLEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2006
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 WILKINS DR
FAYETTEVILLE NC
28311-9338
US

IV. Provider business mailing address

7532 WILKINS DR
FAYETTEVILLE NC
28311-9338
US

V. Phone/Fax

Practice location:
  • Phone: 910-868-6000
  • Fax:
Mailing address:
  • Phone: 910-223-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP9418
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: