Individual
CASEY ALLEN HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 CHAMPIONS DR, MIZZOU SPORTS MEDICINE, COLUMBIA, MO 65211-0001
(573) 882-2375
Mailing address
100 MATC, COLUMBIA, MO 65211
(573) 882-2375
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007002739
MO
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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