Provider Demographics
NPI:1629333968
Name:HURLEY, KEVIN MICHAEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:HURLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:495 WINN WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1736
Mailing Address - Country:US
Mailing Address - Phone:404-294-1313
Mailing Address - Fax:404-294-1318
Practice Address - Street 1:495 WINN WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1736
Practice Address - Country:US
Practice Address - Phone:404-294-1313
Practice Address - Fax:404-294-1318
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT010690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist