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General NPI Number Information
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NPI Number | 1124389218
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Entity Type | Organization
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Legal Business Name | LAURA HORN PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 1158 E COLORADO BLVD
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City | PASADENA
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State | CA
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Zip | 91106-1403
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Country | US
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Telephone | 323-314-3415
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Fax | 323-982-9018
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Provider Business Mailing Address
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Address Line | 5207 LOLETA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90041-1503
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Country | US
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Telephone | 323-314-3415
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Fax | 323-982-9018
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Authorized Official
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Title or Position | OWNER
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Name | LAURA LYNN HORN
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Credential | MPT
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Telephone | 323-314-3415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT25906
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License Number State | CA
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