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General NPI Number Information
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NPI Number | 1275527103
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Entity Type | Individual
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Provider Name | MICHAEL J HORAN ATC
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 62 SWAMP RD
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City | NEWTOWN
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State | PA
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Zip | 18940-1578
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Country | US
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Telephone | 215-944-1368
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Fax |
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Provider Business Mailing Address
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Address Line | 36 EAGLE RD
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City | NEWTOWN
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State | PA
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Zip | 18940-1304
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Country | US
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Telephone | 215-534-6783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT001852A
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License Number State | PA
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