Healthcare Provider Details

I. General information

NPI: 1386638914
Provider Name (Legal Business Name): APRIL L HURST PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 LINCOLN RD SUITE B-3
IDABEL OK
74745-7345
US

IV. Provider business mailing address

PO BOX 3070
TEXARKANA TX
75504-3070
US

V. Phone/Fax

Practice location:
  • Phone: 580-286-4842
  • Fax: 903-735-5399
Mailing address:
  • Phone: 903-735-5357
  • Fax: 903-735-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 2933
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: