Provider Demographics
NPI:1710524343
Name:HURLEY, CASEY ANNE (DPT)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ANNE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 HEDGE APPLE DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-8960
Mailing Address - Country:US
Mailing Address - Phone:660-473-1732
Mailing Address - Fax:
Practice Address - Street 1:7315 E FRONTAGE RD STE 120
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1658
Practice Address - Country:US
Practice Address - Phone:913-676-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist