MEDICARE: CHAD R HURST DC

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	111N00000X	Chiropractor	CH00033760	WA

General Provider Information

NPI Number	:	1114918703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD R HURST DC

Provider Business Mailing Address
First Line	:	1120 GRANT ROAD
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802
Country	:	US
Telephone Number	:	509-884-7163
Fax Number	:	509-884-2363

Provider Business Practice Location Address
First Line	:	1120 GRANT ROAD
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802
Country	:	US
Telephone Number	:	509-884-7163
Fax Number	:	509-884-2363

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	10/10/2007

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Directions to “ CHAD R HURST DC” Practice Location

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