THADDEUS HAIRSTON

LIVERPOOL, NY
NPI1356756019
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  251862-1)
Enumeration Date2014-06-21
Last Update Date2014-06-21
Business Address
-- THADDEUS HAIRSTON
1015 7TH NORTH ST APT A2
LIVERPOOL, NY 13088-6138
Phone number: 315-491-8814
Mailing Address
-- THADDEUS HAIRSTON
1015 7TH NORTH ST APT A2
LIVERPOOL, NY 13088-6138
Phone number:
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