Provider Demographics
NPI:1114329075
Name:HORTON SPINE & SPORT LLC
Entity Type:Organization
Organization Name:HORTON SPINE & SPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-454-2100
Mailing Address - Street 1:5748 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3998
Mailing Address - Country:US
Mailing Address - Phone:816-454-2100
Mailing Address - Fax:816-454-2122
Practice Address - Street 1:5748 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-3998
Practice Address - Country:US
Practice Address - Phone:816-454-2100
Practice Address - Fax:816-454-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014032168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty