MEDICARE: JENNIFER HURRELL P.T.M.S.

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	225100000X	Physical Therapist	PT01716	RI

General Provider Information

NPI Number	:	1760436760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HURRELL P.T.M.S.

Provider Business Mailing Address
First Line	:	158A INDIGO POINT RD
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-6156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 POINT JUDITH RD
Second Line	:	SUITE 47
City	:	NARRAGANSETT
State	:	RI
Zip	:	02882-3477
Country	:	US
Telephone Number	:	401-789-2077
Fax Number	:	401-782-4762

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	05/18/2013

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