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Individual

SARAH JOANNE LAQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
880 E END RD, HOMER, AK 99603-7201
(907) 226-2228
(907) 226-2230
Mailing address
880 E END RD, HOMER, AK 99603-7201
(907) 226-2228
(907) 226-2230

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
108930
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600266601
AK
Enumeration date
02/19/2019
Last updated
02/19/2019
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