Provider Demographics
NPI:1801600390
Name:HAYES, TRINA D (PTA)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:D
Last Name:HAYES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 MOON RD
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72947-5500
Mailing Address - Country:US
Mailing Address - Phone:479-406-7109
Mailing Address - Fax:
Practice Address - Street 1:2713 S 74TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5170
Practice Address - Country:US
Practice Address - Phone:479-484-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA2144225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant