Individual
LORI HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 KNOB DR, RIDGEWAY, VA 24148-3915
(276) 732-8732
Mailing address
200 KNOB DR, RIDGEWAY, VA 24148-3915
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/23/2017
Last updated
09/23/2017
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