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NPI Code Detail

MEDICARE: RYAN HORNE OTR

MEDICARE:   RYAN  HORNE  OTR
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1821583014
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN HORNE OTR
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 E WASHINGTON ST
Second Line :
City : SHENANDOAH
State : PA
Zip : 17976-1701
Country : US
Telephone Number : 570-462-1908
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2018
Last Update Date : 08/07/2024

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Directions to “ RYAN HORNE OTR” Practice Location

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