Provider Demographics
NPI:1538662986
Name:HAFER, CHRISTINE (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
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 1:4300 SHREWBURY PL
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-3761
Mailing Address - Country:US
Mailing Address - Phone:813-607-0475
Mailing Address - Fax:
Practice Address - Street 1:4300 SHREWBURY PL
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-3761
Practice Address - Country:US
Practice Address - Phone:813-607-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty