Provider Demographics
NPI:1417315268
Name:HAFNER, CODY HARRINGTON (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:CODY
Middle Name:HARRINGTON
Last Name:HAFNER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FITNESS WAY
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2423
Mailing Address - Country:US
Mailing Address - Phone:302-234-1030
Mailing Address - Fax:302-234-1032
Practice Address - Street 1:100 FITNESS WAY
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-2423
Practice Address - Country:US
Practice Address - Phone:302-234-1030
Practice Address - Fax:302-234-1032
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist