Healthcare Provider Details

I. General information

NPI: 1770670317
Provider Name (Legal Business Name): JOHN EDWARD HURLEY JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 TOWN PARK BLVD SUITE F
UNIONTOWN OH
44685-7972
US

IV. Provider business mailing address

1020 PORTAGE TRL
CUYAHOGA FALLS OH
44221-3032
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-9863
  • Fax:
Mailing address:
  • Phone: 330-928-4747
  • Fax: 330-230-9700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1567
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: