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General NPI Number Information
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NPI Number | 1689142515
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Entity Type | Individual
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Provider Name | EDDY MARIE HORTON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 1810 OZARKA COLLEGE DR
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City | MOUNTAIN VIEW
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State | AR
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Zip | 72560-6455
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Country | US
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Telephone | 870-269-2110
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Fax |
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Provider Business Mailing Address
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Address Line | 409 GREEN THUMB DR
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City | MARSHALL
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State | AR
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Zip | 72650-7951
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Country | US
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Telephone | 870-448-7989
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR2639
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License Number State | AR
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