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General NPI Number Information
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NPI Number | 1760228332
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Entity Type | Individual
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Provider Name | JON CONNOR HORST DPT
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Gender | Male
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Dates
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Enumeration Date | 07/03/2024
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 1528 WALNUT ST STE 1210
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3609
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Country | US
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Telephone | 215-839-0989
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Fax |
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Provider Business Mailing Address
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Address Line | 2432 JASPER ST UNIT 1
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City | PHILADELPHIA
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State | PA
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Zip | 19125-1240
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Country | US
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Telephone | 717-413-5613
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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