Provider Demographics
NPI:1720085848
Name:HORSEY, RICHARD DAVIS (MPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DAVIS
Last Name:HORSEY
Suffix:
Gender:M
Credentials:MPT
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 1859
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1859
Mailing Address - Country:US
Mailing Address - Phone:410-341-6520
Mailing Address - Fax:410-341-6526
Practice Address - Street 1:32071 BEAVER RUN DR
Practice Address - Street 2:STE B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1773
Practice Address - Country:US
Practice Address - Phone:410-341-6520
Practice Address - Fax:410-341-6526
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19050225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406936600Medicaid
MD095NMedicare ID - Type Unspecified
MD406936600Medicaid