MEDICARE: KAYLA ANN HORTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist		CO

General Provider Information

NPI Number	:	1356162234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA ANN HORTON

Provider Business Mailing Address
First Line	:	8132 LODI LN
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-1604
Country	:	US
Telephone Number	:	931-241-1823
Fax Number	:

Provider Business Practice Location Address
First Line	:	3225 TEMPLETON GAP RD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8728
Country	:	US
Telephone Number	:	931-241-1823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	10/23/2024

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