Provider Demographics
NPI:1669734034
Name:HURLBERT, LAURA E (PT, DPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:HURLBERT
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:E
Other - Last Name:BOEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:18444 N 25TH AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1266
Mailing Address - Country:US
Mailing Address - Phone:623-434-2115
Mailing Address - Fax:623-544-5531
Practice Address - Street 1:123 HOSPITAL DR STE 1008
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3320
Practice Address - Country:US
Practice Address - Phone:800-974-4378
Practice Address - Fax:630-515-1536
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11840-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61372OtherDEAN HEALTH INSURANCE