Provider Demographics
NPI:1427812379
Name:LAGARCE, JANINE ELIZABETH (LMT)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:ELIZABETH
Last Name:LAGARCE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 US HIGHWAY 50 W
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2074
Mailing Address - Country:US
Mailing Address - Phone:636-388-9085
Mailing Address - Fax:
Practice Address - Street 1:1550 US HIGHWAY 50 W
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-2074
Practice Address - Country:US
Practice Address - Phone:636-388-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013016477225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist