Provider Demographics
NPI:1447495403
Name:HURST, JOAN L (JOAN HURST, ABT)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:L
Last Name:HURST
Suffix:
Gender:F
Credentials:JOAN HURST, ABT
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JOAN HURST
Mailing Address - Street 1:825 N ARMSTRONG PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8095
Mailing Address - Country:US
Mailing Address - Phone:208-761-5797
Mailing Address - Fax:
Practice Address - Street 1:725 N 15TH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4020
Practice Address - Country:US
Practice Address - Phone:208-388-0206
Practice Address - Fax:208-388-0206
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist