Provider Demographics
NPI:1912715798
Name:HIRTHLER, MICHAEL R (RN, NC-BC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:HIRTHLER
Suffix:
Gender:M
Credentials:RN, NC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 IRON ROCK CT
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1015
Mailing Address - Country:US
Mailing Address - Phone:267-566-1316
Mailing Address - Fax:
Practice Address - Street 1:1246 FRANKFORD AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3949
Practice Address - Country:US
Practice Address - Phone:267-566-1316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20974H5171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach