MEDICARE: MRS. TIFFANI HORNE BS RRT

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	227900000X	Registered Respiratory Therapist	4861666-5701	UT

General Provider Information

NPI Number	:	1376063404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TIFFANI HORNE BS RRT

Provider Business Mailing Address
First Line	:	4531 S 2025 W
Second Line	:
City	:	ROY
State	:	UT
Zip	:	84067-3307
Country	:	US
Telephone Number	:	801-814-2127
Fax Number	:

Provider Business Practice Location Address
First Line	:	4885 S 900 E STE 107
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3905
Country	:	US
Telephone Number	:	801-266-0399
Fax Number	:	801-266-0421

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

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	06/20/2017

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