Provider Demographics
NPI:1396045050
Name:HORLACHER, NATHAN (BC-HIS)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:HORLACHER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S WOODRUFF AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4369
Mailing Address - Country:US
Mailing Address - Phone:208-524-1112
Mailing Address - Fax:208-524-1113
Practice Address - Street 1:211 S WOODRUFF AVE
Practice Address - Street 2:STE 3
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4369
Practice Address - Country:US
Practice Address - Phone:208-524-1112
Practice Address - Fax:208-524-1113
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-1055237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist