Provider Demographics
NPI:1083881106
Name:HORNER, MARY JO (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:JO
Last Name:HORNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1885 W 120TH AVE
Mailing Address - Street 2:SUITE #500
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3279
Mailing Address - Country:US
Mailing Address - Phone:303-280-3023
Mailing Address - Fax:303-254-5660
Practice Address - Street 1:1885 W 120TH AVE
Practice Address - Street 2:SUITE #500
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3279
Practice Address - Country:US
Practice Address - Phone:303-280-3023
Practice Address - Fax:303-254-5660
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor