MEDICARE: WILLIAM HORTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA-05157	OH

General Provider Information

NPI Number	:	1053569277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HORTON

Provider Business Mailing Address
First Line	:	1238 TREVOR CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1238 TREVOR CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1781
Country	:	US
Telephone Number	:	614-274-6583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	08/29/2008

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