Provider Demographics
NPI:1013295385
Name:ROLLINS, LISETTE M (DC)
Entity type:Individual
Prefix:DR
First Name:LISETTE
Middle Name:M
Last Name:ROLLINS
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 1:906 OAK TREE AVE STE K
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-364-1295
Mailing Address - Fax:908-320-8400
Practice Address - Street 1:906 OAK TREE AVE STE K
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-364-1295
Practice Address - Fax:908-320-8400
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011991111N00000X
NJ38MC00710000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor