MEDICARE: ANDREW FRANCIS HURLA MS, ATC, LAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	24-00280	KS

General Provider Information

NPI Number	:	1083732036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW FRANCIS HURLA MS, ATC, LAT

Provider Business Mailing Address
First Line	:	222 S KANSAS ST
Second Line	:
City	:	RUSSELL
State	:	KS
Zip	:	67665-3000
Country	:	US
Telephone Number	:	785-483-0740
Fax Number	:	785-483-0741

Provider Business Practice Location Address
First Line	:	222 S KANSAS ST
Second Line	:
City	:	RUSSELL
State	:	KS
Zip	:	67665-3000
Country	:	US
Telephone Number	:	785-483-0740
Fax Number	:	785-483-0741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	02/25/2015

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