Healthcare Provider Details

I. General information

NPI: 1407809775
Provider Name (Legal Business Name): MICHAEL SEAN HURLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 12/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 GORDON DR
EXTON PA
19341-1201
US

IV. Provider business mailing address

315 GORDON DR
EXTON PA
19341-1201
US

V. Phone/Fax

Practice location:
  • Phone: 610-594-8522
  • Fax: 610-594-8001
Mailing address:
  • Phone: 610-594-8522
  • Fax: 610-594-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC006464L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: