Basic Information
| Provider Information | |||||||||
| NPI: | 1588893903 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORN | ||||||||
| FirstName: | KYLE | ||||||||
| MiddleName: | MITCHELL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1424 25TH ST N | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352342819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053285870 | ||||||||
| FaxNumber: | 2053236624 | ||||||||
| Practice Location | |||||||||
| Address1: | 1424 25TH ST N | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352342819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053285870 | ||||||||
| FaxNumber: | 2053236624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2009 | ||||||||
| LastUpdateDate: | 07/07/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 1976 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.