Provider Demographics
NPI:1336247329
Name:HORTON, DANA RENAE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:RENAE
Last Name:HORTON
Suffix:
Gender:F
Credentials:DC
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 597
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-0010
Mailing Address - Country:US
Mailing Address - Phone:205-699-4433
Mailing Address - Fax:205-699-4438
Practice Address - Street 1:7713 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-2116
Practice Address - Country:US
Practice Address - Phone:205-699-4433
Practice Address - Fax:205-699-4438
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU51634Medicare UPIN
AL000074747Medicare ID - Type Unspecified