Healthcare Provider Details

I. General information

NPI: 1770300485
Provider Name (Legal Business Name): LOIS HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 W ORANGE ST
SHIPPENSBURG PA
17257-1741
US

IV. Provider business mailing address

144 W ORANGE ST
SHIPPENSBURG PA
17257-1741
US

V. Phone/Fax

Practice location:
  • Phone: 717-809-9492
  • Fax:
Mailing address:
  • Phone: 717-809-9492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: