Provider Demographics
NPI:1073070371
Name:DR BEAU A HORNER LLC
Entity Type:Organization
Organization Name:DR BEAU A HORNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-470-0133
Mailing Address - Street 1:10221 N 32ND ST STE G
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3849
Mailing Address - Country:US
Mailing Address - Phone:480-470-0133
Mailing Address - Fax:602-429-8368
Practice Address - Street 1:10221 N 32ND ST STE G
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3849
Practice Address - Country:US
Practice Address - Phone:480-470-0133
Practice Address - Fax:602-429-8368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-23
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty