Individual
JEREMIE FRANC LARAQUE-TWO ELK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, MPH
Contact information
Practice address
9040A JACKSON AVE, TACOMA, WA 98431-3060
(253) 968-1110
Mailing address
6434 JEFFREY CT SE, LACEY, WA 98513-6531
(720) 422-0262
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61140942
WA
Other
Enumeration date
03/22/2021
Last updated
11/09/2022
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