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NPI Code Detail

MEDICARE: JACOB HURLEY DPT

MEDICARE: JACOB HURLEY DPT
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 TherapistPT020176OH
2225100000XPhysical TherapistPT029663PA

General Provider Information

NPI Number : 1669147716
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB HURLEY DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-541-1974
Fax Number :
Provider Business Practice Location Address
First Line : 731 BETA DR
Second Line :
City : MAYFIELD
State : OH
Zip : 44143-2366
Country : US
Telephone Number : 440-461-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2021
Last Update Date : 04/04/2023

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