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General NPI Number Information
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NPI Number | 1831108299
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Entity Type | Organization
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Legal Business Name | SCOTT L HORA OD LLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 430 ARLINGTON RD STE B
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City | BROOKVILLE
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State | OH
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Zip | 45309-1103
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Country | US
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Telephone | 937-770-1265
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Fax | 937-770-1268
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Provider Business Mailing Address
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Address Line | 8300 NATIONAL RD
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City | BROOKVILLE
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State | OH
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Zip | 45309-8636
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Country | US
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Telephone | 937-371-3470
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT LEE HORA
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Credential | O.D.
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Telephone | 937-371-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5395
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License Number State | OH
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