Provider Demographics
NPI:1326040106
Name:HORTON, MAURICE VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:VINCENT
Last Name:HORTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 N COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-6427
Mailing Address - Country:US
Mailing Address - Phone:910-392-1488
Mailing Address - Fax:910-392-1489
Practice Address - Street 1:2307 N COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-6427
Practice Address - Country:US
Practice Address - Phone:910-392-1488
Practice Address - Fax:910-392-1489
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89088536Medicaid
NCU12478Medicare UPIN
NC89088536Medicaid