Provider Demographics
NPI:1154139525
Name:HORNE, DAWN MARIE (LMT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HORNE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2154 BUTTERCUP LN
Mailing Address - Street 2:
Mailing Address - City:LIMESTONE
Mailing Address - State:TN
Mailing Address - Zip Code:37681-2343
Mailing Address - Country:US
Mailing Address - Phone:423-946-9347
Mailing Address - Fax:
Practice Address - Street 1:4729 N ROAN ST STE 1N
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-3886
Practice Address - Country:US
Practice Address - Phone:423-946-9347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10871225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist