Individual
TIFFANY HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2144 MAPLECREST DR, CHARLOTTE, NC 28212-6918
(980) 230-9405
Mailing address
2144 MAPLECREST DR, CHARLOTTE, NC 28212-6918
(980) 230-9405
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A4601
NC
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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