Individual
KIBRA LA'TISE VANHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
185 E MAIN ST STE 405, BENTON HARBOR, MI 49022-4432
(269) 588-1119
Mailing address
1388 SAINT THOMAS ST UNIT B, BENTON HARBOR, MI 49022-3908
(269) 861-1169
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
1012128
CA
Other
Enumeration date
06/17/2025
Last updated
09/11/2025
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