Provider Demographics
NPI:1942024377
Name:VANHORN, ANTHONY BLAINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:BLAINE
Last Name:VANHORN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:734-416-3900
Mailing Address - Fax:734-453-2118
Practice Address - Street 1:6012 LINDEN RD STE 15
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-8889
Practice Address - Country:US
Practice Address - Phone:810-655-8244
Practice Address - Fax:810-655-2192
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501303588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist