Individual
MR. MICHAEL HURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
913 11TH ST SE, SUITE 1, BANDON, OR 97411-9168
(541) 347-4314
(541) 347-8006
Mailing address
913 11TH ST SE, SUITE 1, BANDON, OR 97411-9168
(541) 347-4314
(541) 347-8006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
979681
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028176
—
OR
Enumeration date
08/28/2006
Last updated
07/08/2007
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