MEDICARE: DAWN MARIE HORNE LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	10871	TN

General Provider Information

NPI Number	:	1154139525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MARIE HORNE LMT

Provider Business Mailing Address
First Line	:	2154 BUTTERCUP LN
Second Line	:
City	:	LIMESTONE
State	:	TN
Zip	:	37681-2343
Country	:	US
Telephone Number	:	423-946-9347
Fax Number	:

Provider Business Practice Location Address
First Line	:	4729 N ROAN ST STE 1N
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37615-3886
Country	:	US
Telephone Number	:	423-946-9347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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