MEDICARE: DONALD J LAVIGNE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	MC 04886	NJ

General Provider Information

NPI Number	:	1912939638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD J LAVIGNE D.C.

Provider Business Mailing Address
First Line	:	40 MORRISTOWN RD
Second Line	:	SUITE 1B
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2310
Country	:	US
Telephone Number	:	908-766-5663
Fax Number	:	908-766-7768

Provider Business Practice Location Address
First Line	:	40 MORRISTOWN RD
Second Line	:	SUITE 1B
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2310
Country	:	US
Telephone Number	:	908-766-5663
Fax Number	:	908-766-7768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/21/2012

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