Provider Demographics
NPI:1831544543
Name:HORNUNG, NATHAN (DPT)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:HORNUNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10930 W POTTER RD STE C
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3450
Mailing Address - Country:US
Mailing Address - Phone:414-400-6556
Mailing Address - Fax:
Practice Address - Street 1:10930 W POTTER RD STE C
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3450
Practice Address - Country:US
Practice Address - Phone:414-400-6556
Practice Address - Fax:414-400-6557
Is Sole Proprietor?:No
Enumeration Date:2016-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI117002251X0800X
WI1170024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic