Provider Demographics
NPI:1407891229
Name:TINKLEPAUGH-HAIRSTON, VALERIE MARIE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:TINKLEPAUGH-HAIRSTON
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10905 MIDDLEGLEN RD
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-6173
Mailing Address - Country:US
Mailing Address - Phone:817-343-1534
Mailing Address - Fax:817-257-6640
Practice Address - Street 1:2900 STADIUM DR
Practice Address - Street 2:DMC SPORTS MEDICINE
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76129-0001
Practice Address - Country:US
Practice Address - Phone:817-257-6647
Practice Address - Fax:817-257-6640
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer