MEDICARE: SCOTT L HORA OD LLC

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	152W00000X	Optometrist	5395	OH

General Provider Information

NPI Number	:	1831108299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT L HORA OD LLC

Provider Business Mailing Address
First Line	:	8300 NATIONAL RD
Second Line	:
City	:	BROOKVILLE
State	:	OH
Zip	:	45309-8636
Country	:	US
Telephone Number	:	937-371-3470
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 ARLINGTON RD
Second Line	:	STE B
City	:	BROOKVILLE
State	:	OH
Zip	:	45309-1103
Country	:	US
Telephone Number	:	937-770-1265
Fax Number	:	937-770-1268

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SCOTT LEE HORA
Credential	:	O.D.
Telephone Number	:	937-371-3470

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	09/21/2012

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