Individual
GLEN EDWARD HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
133 E MARKET ST STE 102, MARTINSVILLE, VA 24112-3740
(276) 806-9177
Mailing address
PO BOX 3148, MARTINSVILLE, VA 24115-3148
(276) 806-9177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/28/2020
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