Individual ProviderThomas HordtPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansPractice Address235 Wealthy St SE, Grand Rapids, MI 49503-5247(616) 840-8000PECOS EnrollmentBased on the most recent information from CMS, provider Thomas Hordt is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 10:10 AM.Profile DetailsProvider ID1336593284Provider TypeIndividualFull NameHordt, ThomasGenderMaleSole ProprietorNoEnumeration Date4/18/2016Last Updated3/31/2021Contact InformationPractice LocationPractice Address235 Wealthy St SE, Grand Rapids, MI 49503-5247Phone(616) 840-8000FaxUnlisted FaxMailing LocationMailing Address235 Wealthy St SE, Grand Rapids, MI 49503-5247PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208100000XPrimaryDescriptionPhysical Medicine & RehabilitationAllopathic & Osteopathic PhysiciansLicense4301503047Michigan