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1235293556
MARK GLENN HAYNES
MOUNTAIN HOME, AR
NPI
1235293556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AR 128)
Enumeration Date
2006-12-21
Last Update Date
2007-07-08
Business Address
MARK GLENN HAYNES ATC
302 LEATHERWOOD DR
MOUNTAIN HOME, AR 72653-3702
Phone number: 870-424-3554
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Mailing Address
MARK GLENN HAYNES ATC
302 LEATHERWOOD DR
MOUNTAIN HOME, AR 72653-3702
Phone number: 870-424-3554
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