Provider Demographics
NPI:1437588654
Name:HURLEY, ROBIN (LPTA, LMT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:LPTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4992 MARSHLAKE LN
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1226
Mailing Address - Country:US
Mailing Address - Phone:703-371-0550
Mailing Address - Fax:
Practice Address - Street 1:4992 MARSHLAKE LN
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1226
Practice Address - Country:US
Practice Address - Phone:703-371-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019018399225700000X
VA2306602379225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist