Provider Demographics
NPI:1346653680
Name:HORTONS ORTHOTIC LAB, INC.
Entity Type:Organization
Organization Name:HORTONS ORTHOTIC LAB, INC.
Other - Org Name:HORTONS ORHTOTICS & PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-847-6999
Mailing Address - Street 1:5220 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1857
Mailing Address - Country:US
Mailing Address - Phone:501-663-2908
Mailing Address - Fax:501-663-3994
Practice Address - Street 1:4020 RICHARDS RD
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2650
Practice Address - Country:US
Practice Address - Phone:501-945-0404
Practice Address - Fax:501-945-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier