Provider Demographics
NPI:1144415043
Name:DR. LARRY E. HORN. P.A.
Entity Type:Organization
Organization Name:DR. LARRY E. HORN. P.A.
Other - Org Name:HORN CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-863-7811
Mailing Address - Street 1:718 W GROVE ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4416
Mailing Address - Country:US
Mailing Address - Phone:870-863-7811
Mailing Address - Fax:870-863-5373
Practice Address - Street 1:718 W GROVE ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4416
Practice Address - Country:US
Practice Address - Phone:870-863-7811
Practice Address - Fax:870-863-5373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ART20647Medicare UPIN