Provider Demographics
NPI:1851536916
Name:HAFNER, CHRISTOPHER JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:HAFNER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3064
Mailing Address - Country:US
Mailing Address - Phone:651-227-6865
Mailing Address - Fax:
Practice Address - Street 1:1032 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3064
Practice Address - Country:US
Practice Address - Phone:651-227-6865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1063171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist