Provider Demographics
NPI:1114024676
Name:HORIZON INTEGRATED MEDICINE PC
Entity Type:Organization
Organization Name:HORIZON INTEGRATED MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-938-9125
Mailing Address - Street 1:17606 N 59TH AVE SUITE 3
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308
Mailing Address - Country:US
Mailing Address - Phone:602-938-9125
Mailing Address - Fax:602-938-9207
Practice Address - Street 1:17606 N 59TH AVE SUITE 3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-938-9125
Practice Address - Fax:602-938-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ84470Medicare ID - Type UnspecifiedMEDICARE NUMBER