Provider Demographics
NPI:1215149372
Name:LABARRE, CHARLES W (LAC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:W
Last Name:LABARRE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 ORIOLE DR
Mailing Address - Street 2:PO BOX 603
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1919
Mailing Address - Country:US
Mailing Address - Phone:845-679-6570
Mailing Address - Fax:
Practice Address - Street 1:26 ORIOLE DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1919
Practice Address - Country:US
Practice Address - Phone:845-679-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000403171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist