Healthcare Provider Details

I. General information

NPI: 1265492383
Provider Name (Legal Business Name): JAMES RAYMOND HURLEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 MEMORIAL BLVD SUITE E
CONNELLSVILLE PA
15425-1488
US

IV. Provider business mailing address

4020 ADELAIDE HLS
CONNELLSVILLE PA
15425-6222
US

V. Phone/Fax

Practice location:
  • Phone: 724-626-8890
  • Fax: 724-626-2983
Mailing address:
  • Phone: 724-626-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC004033L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: