Individual
REBECCA J HAFNER-FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
33491 135TH AVE, AVON, MN 56310-9617
(320) 356-1019
Mailing address
33491 135TH AVE, AVON, MN 56310-9617
(320) 356-1019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25004
MN
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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