Provider Demographics
NPI:1437819505
Name:HORVATH, EMMA (PTA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:HORVATH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11565 ALGONQUIN DR
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9520
Mailing Address - Country:US
Mailing Address - Phone:734-945-8667
Mailing Address - Fax:
Practice Address - Street 1:29665 WILLIAM K SMITH DR STE B
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-8581
Practice Address - Country:US
Practice Address - Phone:517-420-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502006520225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant