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General NPI Number Information
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NPI Number | 1780119339
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Entity Type | Individual
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Provider Name | BROOKE HORNER
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Gender | Female
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 12400 HIGH BLUFF DR
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City | SAN DIEGO
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State | CA
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Zip | 92130-3077
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Country | US
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Telephone | 866-871-8519
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 GRIFFITH DR
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City | CORTLAND
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State | OH
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Zip | 44410-9603
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Country | US
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Telephone | 330-261-3665
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016494
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1282399
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 006951
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 26175
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License Number State | MD
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