Provider Demographics
NPI:1336194943
Name:THORNE, DIANN (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:DIANN
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
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 1:810 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-5964
Mailing Address - Country:US
Mailing Address - Phone:817-657-8027
Mailing Address - Fax:
Practice Address - Street 1:810 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5964
Practice Address - Country:US
Practice Address - Phone:817-657-8027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00081417OtherRAILROAD PIIN
TX162949501Medicaid
TXQ03326Medicare UPIN