Individual
MARK HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 N PARKWAY DR, ALVARADO, TX 76009-3724
(817) 790-3304
Mailing address
101 N PARKWAY DR, ALVARADO, TX 76009-3724
(817) 790-3304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211465
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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