Provider Demographics
NPI:1093920936
Name:HAFER, TERRY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:HAFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8542 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-9738
Mailing Address - Country:US
Mailing Address - Phone:610-837-8383
Mailing Address - Fax:610-837-7373
Practice Address - Street 1:8542 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-9738
Practice Address - Country:US
Practice Address - Phone:610-837-8383
Practice Address - Fax:610-837-7373
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004234L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation