Provider Demographics
NPI:1598785370
Name:SOTTILE, LAURA C (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:C
Last Name:SOTTILE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1367
Mailing Address - Country:US
Mailing Address - Phone:973-218-6335
Mailing Address - Fax:973-218-6304
Practice Address - Street 1:75 MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1367
Practice Address - Country:US
Practice Address - Phone:973-218-6335
Practice Address - Fax:973-218-6304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00613100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor