Provider Demographics
NPI:1316493372
Name:HORIZON REHAB LLC
Entity type:Organization
Organization Name:HORIZON REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-7171
Mailing Address - Street 1:11 E 200 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4764
Mailing Address - Country:US
Mailing Address - Phone:801-374-1706
Mailing Address - Fax:801-225-7977
Practice Address - Street 1:11 E 200 N
Practice Address - Street 2:SUITE 101
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4764
Practice Address - Country:US
Practice Address - Phone:801-374-1706
Practice Address - Fax:801-225-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy