MEDICARE: MR. ANTHONY P HORNUNG PT

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	2939	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	006806261U	OTHER		HUMANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942251772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY P HORNUNG PT

Provider Business Mailing Address
First Line	:	1155 N MAYFAIR RD
Second Line	:	SPINE CARE CLINIC AT PLANK ROAD
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3421
Country	:	US
Telephone Number	:	414-955-7199
Fax Number	:	414-955-0110

Provider Business Practice Location Address
First Line	:	1155 N MAYFAIR RD
Second Line	:	SPINE CARE CLINIC AT PLANK ROAD
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3421
Country	:	US
Telephone Number	:	414-955-7199
Fax Number	:	414-955-0110

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	01/25/2013

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Directions to “ MR. ANTHONY P HORNUNG PT” Practice Location

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