Provider Demographics
NPI:1285001099
Name:HORNE, KRISTIN K (DPT, OPT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:HORNE
Suffix:
Gender:F
Credentials:DPT, OPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13151 MAGISTERIAL DR # 200
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4103
Mailing Address - Country:US
Mailing Address - Phone:502-587-1236
Mailing Address - Fax:
Practice Address - Street 1:5120 DIXIE HWY STE 103
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1775
Practice Address - Country:US
Practice Address - Phone:502-587-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8723012251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic