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NPI Code Detail

MEDICARE: SYDNEY HURST PT

MEDICARE:   SYDNEY  HURST  PT
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
1225100000XPhysical Therapist5811OK

General Provider Information

NPI Number : 1578170825
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY HURST PT
Provider Business Mailing Address
First Line : 10603 S PAYNE RD
Second Line :
City : MUSTANG
State : OK
Zip : 73064-9727
Country : US
Telephone Number : 405-640-6587
Fax Number :
Provider Business Practice Location Address
First Line : 7415 N MAY AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3201
Country : US
Telephone Number : 405-400-8909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 09/29/2020

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