Individual
LORI JANE LAGERQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
435 S CRYSTAL ST, SUITE 200, BUTTE, MT 59701-1506
(406) 496-3600
(406) 496-3653
Mailing address
435 S CRYSTAL ST, SUITE 200, BUTTE, MT 59701-1506
(406) 496-3600
(406) 496-3653
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
58 (PA-C)
MT
363A00000X
Physician Assistant
Primary
58
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0431847
—
MT
01
—
090173
BCBS OF MT
MT
Enumeration date
10/02/2006
Last updated
10/11/2017
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