MEDICARE: JON CONNOR HORST DPT

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1760228332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON CONNOR HORST DPT

Provider Business Mailing Address
First Line	:	2432 JASPER ST UNIT 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-1240
Country	:	US
Telephone Number	:	717-413-5613
Fax Number	:

Provider Business Practice Location Address
First Line	:	1528 WALNUT ST STE 1210
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3609
Country	:	US
Telephone Number	:	215-839-0989
Fax Number	:

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

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	07/03/2024

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Directions to “ JON CONNOR HORST DPT” Practice Location

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