Provider Demographics
NPI:1780900241
Name:OSBORNE, DAWN LOUSIE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LOUSIE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S 291 HWY
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1201
Mailing Address - Country:US
Mailing Address - Phone:816-373-9328
Mailing Address - Fax:
Practice Address - Street 1:2301 S 291 HWY
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1201
Practice Address - Country:US
Practice Address - Phone:816-373-9328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010010441225100000X
KS11-04069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist