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Individual
JASON CLARK LAGE
Active
Individual
JASON CLARK LAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCTMB
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
HMGT24-0060
MN
225700000X
Massage Therapist
HMGT24-0060
MN
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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