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Individual

MRS. LORIE LANETTE HAGL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1170 TIMBER RUN DR, SAINT LOUIS, MO 63146-4482
(314) 469-0606
(314) 469-3294
Mailing address
49 GARY GLEN DR, SAINT PETERS, MO 63376-1952
(636) 397-7735

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
100391
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4487786022
MO
Enumeration date
02/21/2007
Last updated
07/08/2007
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