Provider Demographics
NPI:1831307081
Name:HAFNER, LAURA ANN (ATC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:HAFNER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:FISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 MORGAN WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-3311
Mailing Address - Country:US
Mailing Address - Phone:603-868-8089
Mailing Address - Fax:
Practice Address - Street 1:9 MORGAN WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-3311
Practice Address - Country:US
Practice Address - Phone:603-868-8089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer