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Individual

CHRISTOPHER D LAVALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
824 ANSON, KINGSLAND, TX 78639-4234
(325) 388-5665
(325) 388-0225
Mailing address
824 ANSON, KINGSLAND, TX 78639-4234
(325) 388-5665
(325) 388-0225

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
TACLA00066994E
TX

Other

Enumeration date
10/06/2020
Last updated
10/06/2020
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