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General NPI Number Information
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NPI Number | 1497210439
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Entity Type | Individual
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Provider Name | TREVOR HOWARD HORNICK
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Gender | Male
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 500 JEFFERSON ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-3634
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Country | US
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Telephone | 910-642-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 WINDLEA RUN
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City | WILMINGTON
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State | NC
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Zip | 28409-2214
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Country | US
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Telephone | 910-352-9638
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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