Individual
MR. BRANDON LAGRECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC
Contact information
Practice address
3278 MAIN ST, EAST TROY, WI 53120-1152
(262) 642-4325
Mailing address
PO BOX 885, EAST TROY, WI 53120-0885
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
555-055
WI
Other
Enumeration date
01/30/2007
Last updated
07/13/2017
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