Provider Demographics
NPI:1730972241
Name:DIMOND, ERIN M (LMT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:DIMOND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 SID SUMMERS RD
Mailing Address - Street 2:
Mailing Address - City:STEWART
Mailing Address - State:TN
Mailing Address - Zip Code:37175-5669
Mailing Address - Country:US
Mailing Address - Phone:815-222-9147
Mailing Address - Fax:
Practice Address - Street 1:318 SPRING ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3245
Practice Address - Country:US
Practice Address - Phone:931-237-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14858225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist