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Individual

BLAISE MITCHELL LAVORGNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
32071 BEAVES RUN DRIVE, SALISBURY, MD 21804
(410) 341-6520
(410) 341-6526
Mailing address
P. O. BOX 1859, SALISBURY, MD 21802-1859
(410) 341-6520
(410) 341-6526

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1405PT
MD

Other

Enumeration date
06/17/2005
Last updated
04/11/2013
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