Provider Demographics
NPI:1629514237
Name:HURRELL, MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:HURRELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-1301
Mailing Address - Country:US
Mailing Address - Phone:978-604-8325
Mailing Address - Fax:
Practice Address - Street 1:820 TURNPIKE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6125
Practice Address - Country:US
Practice Address - Phone:978-604-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist