Provider Demographics
NPI:1114588787
Name:HORNE, SARAH SOUTHARD
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SOUTHARD
Last Name:HORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 CAROLINE LN APT 5
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-5057
Mailing Address - Country:US
Mailing Address - Phone:501-860-5699
Mailing Address - Fax:
Practice Address - Street 1:1102 CAROLINE LN APT 5
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-5057
Practice Address - Country:US
Practice Address - Phone:501-860-5699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer