BLAKE EDWARD HAIRSTON

MARTINSVILLE, VA
NPI1902158280
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2012-10-10
Last Update Date2012-10-10
Business Address
BLAKE EDWARD HAIRSTON
590 NORTHFORK RD
MARTINSVILLE, VA 24112-1353
Phone number: 276-734-6140
Mailing Address
BLAKE EDWARD HAIRSTON
590 NORTHFORK RD
MARTINSVILLE, VA 24112-1353
Phone number: 276-734-6140
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