MEDICARE: HORIZON PHYSICAL THERAPY AND REHABILITATION LLC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1760712673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON PHYSICAL THERAPY AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	PO BOX 1641
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48641-1641
Country	:	US
Telephone Number	:	616-940-0660
Fax Number	:	616-940-1965

Provider Business Practice Location Address
First Line	:	4121 SHRESTHA DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2171
Country	:	US
Telephone Number	:	989-686-6900
Fax Number	:	989-686-6911

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AJAY MIDDHA
Credential	:	DPT
Telephone Number	:	989-686-6900

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	05/10/2010

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