Healthcare Provider Details

I. General information

NPI: 1366655342
Provider Name (Legal Business Name): GAYLA ANN HEARN OTRL, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 BONE ST
CLINTON AR
72031-6609
US

IV. Provider business mailing address

131 BONE ST
CLINTON AR
72031-6609
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-5010
  • Fax: 501-745-5011
Mailing address:
  • Phone: 501-745-5010
  • Fax: 501-745-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR249
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT776
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: