Individual
JEAN LAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
649 E 81ST ST, BROOKLYN, NY 11236-3303
(917) 295-5048
Mailing address
649 E 81ST ST, BROOKLYN, NY 11236-3303
(917) 295-5048
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
X011370-1
NY
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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