Provider Demographics
NPI:1073232559
Name:HORN, AUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:HORN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 PENN AVE S APT 704
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1390
Mailing Address - Country:US
Mailing Address - Phone:218-358-1018
Mailing Address - Fax:
Practice Address - Street 1:33 HAMLINE AVE S # 100
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2231
Practice Address - Country:US
Practice Address - Phone:651-690-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7012111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician