Provider Demographics
NPI:1982934741
Name:LALIN, GAUTIER ANDRE (DC)
Entity Type:Individual
Prefix:DR
First Name:GAUTIER
Middle Name:ANDRE
Last Name:LALIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-2228
Mailing Address - Country:US
Mailing Address - Phone:734-241-4070
Mailing Address - Fax:734-241-0159
Practice Address - Street 1:11 E FRONT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-2228
Practice Address - Country:US
Practice Address - Phone:734-241-4070
Practice Address - Fax:734-241-0159
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor