Provider Demographics
NPI:1821394263
Name:PAYNE, DAWN (MSPT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 S PENDLETON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:69 DOYLE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-3676
Practice Address - Country:US
Practice Address - Phone:706-886-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist