Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501017348 | MI |
NPI | 1003469461 |
---|---|
Provider Name | Joseph Horjus |
First Address | Kalamazoo, MI 49006-4231 |
Second Address | Kalamazoo, MI 49006-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2019 |
Last Update Date | 24/07/2019 |