Provider Demographics
NPI:1750664314
Name:HORST, SHAWNTAE MARIE (PT)
Entity Type:Individual
Prefix:DR
First Name:SHAWNTAE
Middle Name:MARIE
Last Name:HORST
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:6900 A ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4120
Mailing Address - Country:US
Mailing Address - Phone:402-436-2535
Mailing Address - Fax:402-436-2541
Practice Address - Street 1:2801 PINE LAKE RD
Practice Address - Street 2:SUITE K
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6041
Practice Address - Country:US
Practice Address - Phone:402-436-2986
Practice Address - Fax:402-436-2999
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE3047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist