Provider Demographics
NPI:1538276589
Name:HORLBOGEN, JOHN HENRY (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HENRY
Last Name:HORLBOGEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-4421
Mailing Address - Country:US
Mailing Address - Phone:508-761-6334
Mailing Address - Fax:508-761-5515
Practice Address - Street 1:765 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-4421
Practice Address - Country:US
Practice Address - Phone:508-761-6334
Practice Address - Fax:508-761-5515
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI601201743Medicaid
MAY35340Medicare UPIN