Individual
MARYANN MARIE HAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
316 CONSTITUTION DR, RUTHER GLEN, VA 22546-5232
(804) 994-1016
Mailing address
316 CONSTITUTION DR, RUTHER GLEN, VA 22546-5232
(804) 994-1016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604945
VA
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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