Healthcare Provider Details

I. General information

NPI: 1134735319
Provider Name (Legal Business Name): CHRISTIAN HORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EXECUTIVE DR
MARION OH
43302-6373
US

IV. Provider business mailing address

320 EXECUTIVE DR
MARION OH
43302-6373
US

V. Phone/Fax

Practice location:
  • Phone: 740-387-5210
  • Fax: 740-382-3713
Mailing address:
  • Phone: 740-387-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: