Healthcare Provider Details

I. General information

NPI: 1073881660
Provider Name (Legal Business Name): MARIA G HORNUNG PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 STATE ST STE 2
NEW ALBANY IN
47150-4972
US

IV. Provider business mailing address

2700 STANLEY GAULT PKWY STE 129
LOUISVILLE KY
40223-5176
US

V. Phone/Fax

Practice location:
  • Phone: 800-330-7711
  • Fax: 866-426-2811
Mailing address:
  • Phone: 502-253-4914
  • Fax: 502-253-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05010821A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: