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DR. GINA MARIE BONAVITO LARRAGOITE DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1639261308

Individual Registrant:
DR. GINA MARIE BONAVITO LARRAGOITE DC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3624 W ANTHEM WAY SUITE C 110 ANTHEM, AZ 85086 US
Tel: 623-551-9950  Fax: 623-551-2454

Contact information for business:
3624 W ANTHEM WAY SUITE C 110 ANTHEM, AZ 85086 US
Tel: 623-551-9950  Fax: 623-551-2454

Registration Information:
NPI: 1639261308
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
AZ7282

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELDAZ0939890AZ01




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