Individual
STEPHANIE HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
912 BROOKDALE ST, STE 1, MARTINSVILLE, VA 24112
(276) 336-8649
(276) 336-8758
Mailing address
912 BROOKDALE ST, STE 1, MARTINSVILLE, VA 24112
(276) 336-8649
(276) 336-8758
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
534
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343900000X
—
VA
Enumeration date
03/10/2017
Last updated
03/10/2017
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