Individual
JAMIE LYNN HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
109 HOMEWOOD BLVD, GLASGOW, KY 42141-3468
(270) 651-6126
Mailing address
198 S FORK TERRACE RD, GLASGOW, KY 42141-9638
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
49591
CA
225200000X
Physical Therapy Assistant
A03497
KY
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
Primary
CP017255A
MT
Other
Enumeration date
08/23/2016
Last updated
03/17/2023
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