Individual
DR. JACK LAFOSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1374 RICHLAND BLVD, BAY SHORE, NY 11706-4947
(631) 804-9995
Mailing address
1374 RICHLAND BLVD, BAY SHORE, NY 11706-4947
(631) 804-9995
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009251
NY
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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