Healthcare Provider Details

I. General information

NPI: 1891804753
Provider Name (Legal Business Name): WILLIAM J HAFER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 W PENNSYLVANIA AVE
NEW STANTON PA
15672-9474
US

IV. Provider business mailing address

163 W PENNSYLVANIA AVE
NEW STANTON PA
15672-9474
US

V. Phone/Fax

Practice location:
  • Phone: 724-925-2244
  • Fax:
Mailing address:
  • Phone: 724-925-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005358L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: