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Individual

DR. BLAKE LAURSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
8715 VILLAGE DR STE 120, SAN ANTONIO, TX 78217-5425
(210) 477-5151
Mailing address
PO BOX 5730, BELFAST, ME 04915-5700
(888) 402-7256

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2020003790
MO
363A00000X
Physician Assistant
Primary
PA20046
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
02/04/2020
Last updated
04/20/2026
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