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NPI 1891412003

NPI 1891412003 : THOMAS HORVATH : OAK LAWN, IL

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General NPI Number Information
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    NPI Number           |    1891412003
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS HORVATH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/27/2022
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    Last Update Date     |    10/27/2022
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Provider Practice Location Address
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    Address Line         |    4817 W 95TH ST 
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    City                 |    OAK LAWN
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    State                |    IL
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    Zip                  |    60453-2501
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    Country              |    US
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    Telephone            |    708-598-7880
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2N419 BEITH RD 
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    City                 |    ELBURN
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    State                |    IL
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    Zip                  |    60119-9521
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    Country              |    US
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    Telephone            |    
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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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