Provider Demographics
NPI:1760576672
Name:HAEFNER, MARGARET TORY (DPT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:TORY
Last Name:HAEFNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 NORTHLAND CT NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6226
Mailing Address - Country:US
Mailing Address - Phone:319-377-0937
Mailing Address - Fax:319-377-0948
Practice Address - Street 1:227 NORTHLAND CT NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6226
Practice Address - Country:US
Practice Address - Phone:319-377-0937
Practice Address - Fax:319-377-0948
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB4148006OtherMEDICARE ID
IA1400352Medicaid