MEDICARE: KIMBERLY HORN

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	261QP2000X	Physical Therapy Clinic/Center	109025	TX

General Provider Information

NPI Number	:	1457542599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMBERLY HORN

Provider Business Mailing Address
First Line	:	4301 COLLEGE DR
Second Line	:	SUITE 400
City	:	VERNON
State	:	TX
Zip	:	76384-3128
Country	:	US
Telephone Number	:	940-357-1266
Fax Number	:	940-553-1602

Provider Business Practice Location Address
First Line	:	4301 COLLEGE DR
Second Line	:	SUITE 400
City	:	VERNON
State	:	TX
Zip	:	76384-3128
Country	:	US
Telephone Number	:	940-357-1266
Fax Number	:	940-553-1602

Authorized Official
Title or Position	:	OTR/OWNER
Name	:	MRS. KIMBERLY BETH HORN
Credential	:	OTR
Telephone Number	:	940-357-1266

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	07/01/2008

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Directions to “KIMBERLY HORN ” Practice Location

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