Individual provider · Type 1 NPI
Lacy Jaye Waggoner, LMT
Massage Therapist · Oregon, MO
NPI number
1619482015
Active
Practice location
601 E Nodaway St
Oregon, MO 64473-9602
Mailing address
200 Oakland St
Oregon, MO 64473-9200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 2013033098 (MO) |
Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Another provider at this address
About NPI 1619482015
Lacy Jaye Waggoner, LMT's National Provider Identifier is 1619482015, issued on Dec 6, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Oregon, MO. The record was last updated on Dec 6, 2017.