Individual
MICHAEL R HORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1294023
WI
363AM0700X
Medical Physician Assistant
Primary
1294
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004901300
—
WI
Enumeration date
11/08/2005
Last updated
03/17/2018
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