Healthcare Provider Details

I. General information

NPI: 1215521836
Provider Name (Legal Business Name): MADISON L HORNER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 GROVE BEACH RD N
WESTBROOK CT
06498-1656
US

IV. Provider business mailing address

5 HIGH RIDGE PARK FL 2
STAMFORD CT
06905-1332
US

V. Phone/Fax

Practice location:
  • Phone: 860-669-4197
  • Fax: 860-552-4648
Mailing address:
  • Phone: 203-869-1145
  • Fax: 203-618-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13858
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: