Individual
KAITLIN C HORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7550 W EMERALD ST, BOISE, ID 83704
(208) 375-0666
Mailing address
1422 S GOURLEY ST, BOISE, ID 83705-6041
(314) 610-4864
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4451
ID
Other
Enumeration date
12/12/2016
Last updated
07/31/2018
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