Provider Demographics
NPI:1396960688
Name:HORSCH, DEBORA ANN (P T)
Entity type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:ANN
Last Name:HORSCH
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9913 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6920
Mailing Address - Country:US
Mailing Address - Phone:405-691-3200
Mailing Address - Fax:405-691-3204
Practice Address - Street 1:9913 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6920
Practice Address - Country:US
Practice Address - Phone:405-691-3200
Practice Address - Fax:405-691-3204
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 1200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200077490AMedicaid
OK300522073Medicare PIN
OK243410302Medicare PIN