Provider Demographics
NPI:1922178714
Name:HORNER, ALBERT W JR (DC)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:W
Last Name:HORNER
Suffix:JR
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:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38281-0622
Mailing Address - Country:US
Mailing Address - Phone:731-885-0461
Mailing Address - Fax:731-885-1007
Practice Address - Street 1:1307 W REELFOOT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5505
Practice Address - Country:US
Practice Address - Phone:731-885-0461
Practice Address - Fax:731-885-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2006050OtherBCBST PROVIDER ID
TN3676036Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
TN2006050OtherBCBST PROVIDER ID