Laura Alessandra Horner, ATC, LAT

Individual provider Active NPI Athletic Trainer · MC Kenzie, TN

NPI 1124544663 · NPPES record last updated Aug 16, 2017

Key facts

NPI
1124544663
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2075 (TN)
Practice address
325 Cherry Ave
MC Kenzie, TN 38201-1769
Phone
(731) 352-4000
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2075TNMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2075 TN Yes

Addresses

Primary practice location

325 Cherry Ave
MC Kenzie, TN 38201-1769

Mailing address

1052 Main St N
MC Kenzie, TN 38201-1754
Phone (405) 255-2759

Other providers in MC Kenzie, TN

All providers in MC Kenzie, TN · Athletic Trainer in Tennessee

Sources for this page

Verify at the official NPI Registry.