Provider Demographics
NPI:1861114662
Name:HURST, WILLIAM WESTON (DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WESTON
Last Name:HURST
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 BLACK FOREST DR STE 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6541
Mailing Address - Country:US
Mailing Address - Phone:479-435-6712
Mailing Address - Fax:844-317-0394
Practice Address - Street 1:3399 BLACK FOREST DR STE 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6541
Practice Address - Country:US
Practice Address - Phone:479-435-6712
Practice Address - Fax:844-317-0394
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT5193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist