Provider Demographics
NPI:1245832997
Name:HURLEY HEALTH CENTER LLC
Entity type:Organization
Organization Name:HURLEY HEALTH CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-707-2385
Mailing Address - Street 1:8615 CREEDMOOR PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5400
Mailing Address - Country:US
Mailing Address - Phone:484-707-2385
Mailing Address - Fax:
Practice Address - Street 1:760 BARNES BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5314
Practice Address - Country:US
Practice Address - Phone:484-707-2385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty