Individual
JASON CLARK LAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCTMB
Contact information
Practice address
2700 1ST ST N STE 101, SAINT CLOUD, MN 56303-4202
(605) 786-5327
Mailing address
10720 W LAKE RD, RICE, MN 56367-8668
(605) 786-5327
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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