Individual
KC HAFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
652 SOUTH MEDICAL CENTER DRIVE, SUITE 400, ST GEORGE, UT 84790
(435) 251-2650
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 251-2650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2849081206
UT
Other
Enumeration date
07/13/2006
Last updated
10/07/2009
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