Individual provider · NPI-1

Dr. Jack Lafosse, D.C.

Chiropractor · Bay Shore, NY

NPI number1780055996
StatusActive
Last updated in NPPESOct 14, 2015

Details

NPI
1780055996
Entity type
Individual (NPI-1)
Name
Dr. Jack Lafosse
Credential
D.C.
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 14, 2015
Last updated
Oct 14, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X ChiropractorX009251NYYes

Practice location

1374 Richland Blvd
Bay Shore, NY 11706-4947

Phone 631-804-9995

Mailing address

1374 Richland Blvd
Bay Shore, NY 11706-4947

Phone 631-804-9995

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