Provider Demographics
NPI:1407809775
Name:HURLEY, MICHAEL SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SEAN
Last Name:HURLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1201
Mailing Address - Country:US
Mailing Address - Phone:610-594-8522
Mailing Address - Fax:610-594-8001
Practice Address - Street 1:315 GORDON DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1201
Practice Address - Country:US
Practice Address - Phone:610-594-8522
Practice Address - Fax:610-594-8001
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006464L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU49338Medicare UPIN