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General NPI Number Information
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NPI Number | 1447025432
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Entity Type | Organization
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Legal Business Name | HORTON'S ORTHOTIC LAB, INC.
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 2760 BROWNS LN STE A
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City | JONESBORO
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State | AR
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Zip | 72401-7271
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Country | US
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Telephone | 870-641-0444
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Fax | 870-641-0777
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Provider Business Mailing Address
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Address Line | 605 W COMMERCE DR
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City | BRYANT
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State | AR
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Zip | 72022-7510
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Country | US
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Telephone | 501-847-6999
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Fax | 501-847-6999
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Authorized Official
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Title or Position | DIRECTOR
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Name | TONYA HORTON
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Credential |
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Telephone | 501-847-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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