Provider Demographics
NPI:1588893903
Name:HORN, KYLE MITCHELL (OTR/L)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:MITCHELL
Last Name:HORN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 25TH ST N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35234-2819
Mailing Address - Country:US
Mailing Address - Phone:205-328-5870
Mailing Address - Fax:205-323-6624
Practice Address - Street 1:1424 25TH ST N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35234-2819
Practice Address - Country:US
Practice Address - Phone:205-328-5870
Practice Address - Fax:205-323-6624
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist