Individual
MR. ROBERT E LAVICTOIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CH
Contact information
Practice address
818 W 5TH ST, WASHINGTON, NC 27889-4204
(252) 946-0148
(252) 946-0148
Mailing address
818 W 5TH ST, WASHINGTON, NC 27889-4204
(252) 946-0148
(252) 946-0148
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1499
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08551
BLUE CROSS BLUE SHIELD
—
05
—
89-08551
—
NC
Enumeration date
09/26/2006
Last updated
12/14/2007
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