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General NPI Number Information
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NPI Number | 1447985122
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Entity Type | Individual
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Provider Name | MAKENZIE HURLEY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 3380 NORTHERN VALLEY PL NE
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City | ROCHESTER
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State | MN
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Zip | 55906-3954
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Country | US
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Telephone | 507-259-1026
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Fax |
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Provider Business Mailing Address
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Address Line | 10127 COUNTY ROAD 10 SE
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City | CHATFIELD
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State | MN
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Zip | 55923-3530
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Country | US
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Telephone | 507-259-1026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 106883
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License Number State | MN
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