Provider Demographics
NPI:1538433867
Name:LAVERGNE, CRISTINA IRENE (DC)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:IRENE
Last Name:LAVERGNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194295
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4295
Mailing Address - Country:US
Mailing Address - Phone:787-509-6575
Mailing Address - Fax:
Practice Address - Street 1:380 CALLE JUAN CALAF
Practice Address - Street 2:MONTEMAR PLAZA 7C
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1324
Practice Address - Country:US
Practice Address - Phone:787-509-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor