Individual
LAUWANNA R LARUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-2230
Mailing address
749 MCCUBBINS DR, LINN CREEK, MO 65052-1729
(573) 216-5510
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2004014743
MO
Other
Enumeration date
06/13/2008
Last updated
06/13/2008
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