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General NPI Number Information
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NPI Number | 1942240817
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Entity Type | Individual
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Provider Name | LAWRENCE J HORN MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | REHABILITATION INSTITUTE OF MICHIGAN 261 MACK BLVD
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-745-4600
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Fax | 313-745-1063
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Provider Business Mailing Address
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Address Line | 1560 E MAPLE RD SUITE 400-CREDENTIALING
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City | TROY
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State | MI
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Zip | 48083-1138
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Country | US
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Telephone | 313-745-4600
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Fax | 313-745-1063
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD2018-0791
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301085039
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License Number State | MI
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