Provider Demographics
NPI:1689469520
Name:HORTON'S ORTHOTIC LAB, INC.
Entity type:Organization
Organization Name:HORTON'S ORTHOTIC LAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-847-0999
Mailing Address - Street 1:605 W COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-7510
Mailing Address - Country:US
Mailing Address - Phone:501-847-6999
Mailing Address - Fax:501-847-0099
Practice Address - Street 1:700 HARRISON ST STE C
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-6902
Practice Address - Country:US
Practice Address - Phone:870-569-0033
Practice Address - Fax:501-847-0099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORTON'S ORTHOTIC LAB, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier