Organization
NORTHEAST LIFESTYLE MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH PAUL LAVALLIERE D.C. (OWNER)
(603) 647-0600
Entity
Organization
Contact information
Practice address
360 ROUTE 101, UNIT # 7, BEDFORD, NH 03110-5030
(603) 647-0600
(603) 647-0633
Mailing address
360 ROUTE 101, UNIT # 7, BEDFORD, NH 03110-5030
(603) 647-0600
(603) 647-0633
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
826-0908
NH
Other
Enumeration date
01/03/2011
Last updated
06/24/2016
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