Provider Demographics
NPI:1407948169
Name:HURST, TYLER S (DC)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:S
Last Name:HURST
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 1:1246 OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-1840
Mailing Address - Country:US
Mailing Address - Phone:208-678-8184
Mailing Address - Fax:208-678-8164
Practice Address - Street 1:1246 OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-1840
Practice Address - Country:US
Practice Address - Phone:208-678-8184
Practice Address - Fax:208-678-8164
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor