Provider Demographics
NPI:1962578344
Name:HAFELY, CHRISTOPHER M (DC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:M
Last Name:HAFELY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 CHURCHILL ROAD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420
Mailing Address - Country:US
Mailing Address - Phone:330-545-8560
Mailing Address - Fax:330-545-5585
Practice Address - Street 1:447 CHURCHILL ROAD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420
Practice Address - Country:US
Practice Address - Phone:330-545-8560
Practice Address - Fax:330-545-5585
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2317755Medicaid
OH4015741Medicare ID - Type Unspecified
OH2317755Medicaid