MEDICARE: DR. JOHN EDWARD HURLEY JR. D.C.

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	111NX0800X	Orthopedic Chiropractor	1567	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770670317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN EDWARD HURLEY JR. D.C.

Provider Business Mailing Address
First Line	:	1020 PORTAGE TRL
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44221-3032
Country	:	US
Telephone Number	:	330-928-4747
Fax Number	:	330-230-9700

Provider Business Practice Location Address
First Line	:	1790 TOWN PARK BLVD
Second Line	:	SUITE F
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7972
Country	:	US
Telephone Number	:	330-899-9863
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	12/22/2016

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