Provider Demographics
NPI:1225081375
Name:HORIZON PHYSICAL THERAPY
Entity Type:Organization
Organization Name:HORIZON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, ATC
Authorized Official - Phone:340-776-7667
Mailing Address - Street 1:PO BOX 8649
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1649
Mailing Address - Country:US
Mailing Address - Phone:340-776-7667
Mailing Address - Fax:340-714-1891
Practice Address - Street 1:9154 ESTATE THOMAS
Practice Address - Street 2:M.M. ELECTRIC BUILDING LOWER LEVEL
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2687
Practice Address - Country:US
Practice Address - Phone:340-776-7667
Practice Address - Fax:340-714-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI00-72893Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER