Healthcare Provider Details

I. General information

NPI: 1245083351
Provider Name (Legal Business Name): JULIE MARIE HURLEY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 CAMDEN HWY
SUMTER SC
29153-8233
US

IV. Provider business mailing address

4035 BUSH BRANCH RD
SUMTER SC
29154-9667
US

V. Phone/Fax

Practice location:
  • Phone: 254-247-9221
  • Fax:
Mailing address:
  • Phone: 254-247-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9099
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: