Individual
MR. WILLAIM J. HAYNES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
501 N HERVEY ST, ATTN: MICHAEL A. SMITH, HOPE, AR 71801-3435
(870) 777-6798
(870) 777-6880
Mailing address
418 ROSSTON RD, PRESCOTT, AR 71857-2533
(870) 887-2622
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT129
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT129
ATHLETIC TRAINER LIC.
AR
Enumeration date
10/13/2005
Last updated
07/08/2007
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