Individual
BRENDA HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.H.S. /P.T.
Contact information
Practice address
626 W KANSAS AVE, CHICKASHA, OK 73018-3322
(405) 222-5030
(405) 222-5050
Mailing address
3666 STATE HIGHWAY 92, CHICKASHA, OK 73018-7014
(405) 222-5030
(405) 222-5050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 464
OK
2251N0400X
Neurology Physical Therapist
PT 464
OK
2251P0200X
Pediatric Physical Therapist
PT 464
OK
2251X0800X
Orthopedic Physical Therapist
PT 464
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201994098001
BLUE CROSS BLUE SHIELDS
—
01
—
PT 464
PHYSICAL THER. LIC. #
OK
Enumeration date
07/25/2006
Last updated
03/31/2008
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