Provider Demographics
NPI:1538309505
Name:HURLEY, LAURA (MSPT, CSCS, CEAS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MSPT, CSCS, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2824
Mailing Address - Country:US
Mailing Address - Phone:781-449-2280
Mailing Address - Fax:781-449-2290
Practice Address - Street 1:114 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2824
Practice Address - Country:US
Practice Address - Phone:781-449-2280
Practice Address - Fax:781-449-2290
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist