Provider Demographics
NPI:1275955676
Name:HURLEY, MICHAEL P JR (MSTOM, LAC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:HURLEY
Suffix:JR
Gender:M
Credentials:MSTOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459A FRANCESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-4705
Mailing Address - Country:US
Mailing Address - Phone:603-860-0693
Mailing Address - Fax:
Practice Address - Street 1:459A FRANCESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:NH
Practice Address - Zip Code:03070-4705
Practice Address - Country:US
Practice Address - Phone:603-860-0693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHACP 219171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist