Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT2427 | AR |
N | 2251P0200X | Physical Therapist - Pediatrics | PT2427 | AR |
NPI | 1104972264 |
---|---|
Provider Name | Mrs. Trinity D Courtney |
First Address | Trumann, AR 72472 |
Second Address | Trumann, AR 72472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 22/04/2014 |