Individual
MR. MARTIN DENNIS HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
215 KIRKLAND RD, COVINGTON, GA 30016-3318
(678) 729-9900
(678) 729-9904
Mailing address
3965 ANNA MARIA CT, CLARKSTON, GA 30021-2701
(404) 292-6393
(678) 729-9904
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN100613
GA
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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