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General NPI Number Information
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NPI Number | 1902894660
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Entity Type | Organization
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Legal Business Name | HAYNES SPORTS THERAPY AND REHAB, INC.
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 206 N HERVEY ST
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City | HOPE
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State | AR
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Zip | 71801-3613
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Country | US
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Telephone | 870-777-6798
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Fax | 870-777-6880
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | HOPE
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State | AR
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Zip | 71802-0068
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Country | US
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Telephone | 870-777-6798
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Fax | 870-777-6880
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM J HAYNES
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Credential |
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Telephone | 870-777-6798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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