Individual
DEMARA HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
600 W NORTH BLVD STE D, LEESBURG, FL 34748-5000
(352) 787-9300
Mailing address
600 W NORTH BLVD STE D, LEESBURG, FL 34748-5000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27614
FL
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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