MEDICARE: MR. KYLE MITCHELL HORN OTR/L

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	225X00000X	Occupational Therapist	1976	AL

General Provider Information

NPI Number	:	1588893903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KYLE MITCHELL HORN OTR/L

Provider Business Mailing Address
First Line	:	1424 25TH ST N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35234-2819
Country	:	US
Telephone Number	:	205-328-5870
Fax Number	:	205-323-6624

Provider Business Practice Location Address
First Line	:	1424 25TH ST N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35234-2819
Country	:	US
Telephone Number	:	205-328-5870
Fax Number	:	205-323-6624

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

Provider Enumeration Date	:	07/07/2009
Last Update Date	:	07/07/2009

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