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1003466582
TIFFANY HAIRSTON
CHARLOTTE, NC
NPI
1003466582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: NC A4601)
Enumeration Date
2019-09-16
Last Update Date
2019-09-16
Business Address
TIFFANY HAIRSTON PTA
2144 MAPLECREST DR
CHARLOTTE, NC 28212-6918
Phone number: 980-230-9405
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Mailing Address
TIFFANY HAIRSTON PTA
2144 MAPLECREST DR
CHARLOTTE, NC 28212-6918
Phone number: 980-230-9405
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