Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00682900 | NJ |
NPI | 1003101387 |
---|---|
Provider Name | Dr. Kris Roberte Laliberte |
First Address | Oakhurst, NJ 07755-1561 |
Second Address | Oakhurst, NJ 07755-1561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2011 |
Last Update Date | 14/06/2011 |