Provider Demographics
NPI:1790973725
Name:HURLEY CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:HURLEY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-513-3322
Mailing Address - Street 1:2100 MEADOWLAKE ROAD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032
Mailing Address - Country:US
Mailing Address - Phone:501-513-3322
Mailing Address - Fax:501-513-3065
Practice Address - Street 1:813 OAK ST
Practice Address - Street 2:SUITE 12
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4473
Practice Address - Country:US
Practice Address - Phone:501-513-3322
Practice Address - Fax:501-513-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4420085OtherUHC
4660907OtherAETNA
AR125985718Medicaid
AR59954OtherMEDICARE
AR59954OtherBCBS
AR14514000040OtherQUALCHOICE
ARU46956OtherUPIN