Individual
MR. BENJMAIN W HURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7061 HALCYON SUMMIT DR, MONTGOMERY, AL 36117-6927
(334) 396-2110
(334) 396-2115
Mailing address
80 TECHNACENTER DR, SUITE 300, MONTGOMERY, AL 36117-6028
(334) 625-5795
(334) 396-4905
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH7899
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13774482
CAQH
AK
01
—
511-73432
BCBS OF AL
AL
01
—
511-73434
BCBS OF AL
AL
01
—
511-73438
BCBS OF AL
AL
01
—
511-73440
BCBS OF AL
AL
Enumeration date
01/05/2016
Last updated
03/15/2016
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