| NPI | 1700955697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAISE MITCHELL LAVORGNA President 410-341-6520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MD 1405PT) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-10-04 |