Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC-004234L | PA |
NPI | 1093920936 |
---|---|
Provider Name | Terry Lynn Hafer |
First Address | Northampton, PA 18067-9738 |
Second Address | Northampton, PA 18067-9738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |