Healthcare Provider Details

I. General information

NPI: 1124387121
Provider Name (Legal Business Name): LAURA ANNE HORSLEY ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 8TH DIVISION RD
COLUMBIA SC
29207-5700
US

IV. Provider business mailing address

3953 WOODVALLEY DR
AIKEN SC
29803-8855
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-2273
  • Fax:
Mailing address:
  • Phone: 803-507-3757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT2230
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1578
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number3272
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: