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Individual

KEVIN C HORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
520 BROOKDALE DR, LOWER LEVEL, STATESVILLE, NC 28677-4108
(704) 872-1037
(704) 872-1987
Mailing address
2800 SAINT LEO STREET, GREENSBORO, NC 27405-3382
(336) 621-9500
(336) 621-0980

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
CP2375
DE
224P00000X
Prosthetist
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7704084
NC
05
7795115
NC
Enumeration date
08/15/2007
Last updated
11/04/2011
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