Provider Demographics
NPI:1467895888
Name:HORNER, DARLA CHRISTINE (CMT)
Entity Type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:CHRISTINE
Last Name:HORNER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81362
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-1362
Mailing Address - Country:US
Mailing Address - Phone:907-978-7043
Mailing Address - Fax:
Practice Address - Street 1:1135 BRECKENRIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-6850
Practice Address - Country:US
Practice Address - Phone:907-978-7043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist