Individual
MR. ANTHONY VINCENT LAVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1520 SUNBOW FALLS LN APT 304, RALEIGH, NC 27609-8110
(516) 761-4880
Mailing address
1520 SUNBOW FALLS LN APT 304, RALEIGH, NC 27609-8110
(516) 761-4880
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19260
NC
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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