Provider Demographics
NPI:1790085645
Name:HORN, MAGGIE ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:ELIZABETH
Last Name:HORN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:ELIZABETH HORN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-0518
Mailing Address - Country:US
Mailing Address - Phone:352-528-0022
Mailing Address - Fax:
Practice Address - Street 1:37 S MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2681
Practice Address - Country:US
Practice Address - Phone:352-528-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist