Provider Demographics
NPI:1104972264
Name:COURTNEY, TRINITY D (PT)
Entity type:Individual
Prefix:MRS
First Name:TRINITY
Middle Name:D
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRINITY
Other - Middle Name:D
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1005 BALCOM LN
Mailing Address - Street 2:ASCENT CHILDREN'S HEALTH SERVICES
Mailing Address - City:TRUMANN
Mailing Address - State:AR
Mailing Address - Zip Code:72472
Mailing Address - Country:US
Mailing Address - Phone:870-483-1461
Mailing Address - Fax:870-483-6520
Practice Address - Street 1:1005 BALCOM LANE
Practice Address - Street 2:ASCENT CHILDREN'S HEALTH SERVICES
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472
Practice Address - Country:US
Practice Address - Phone:870-483-1461
Practice Address - Fax:870-483-6520
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT24272251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics