Provider Demographics
NPI:1467220061
Name:LAPLANTE, JACQUELINE (LMT)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LAPLANTE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N HIGGINS AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4534
Mailing Address - Country:US
Mailing Address - Phone:406-240-9311
Mailing Address - Fax:
Practice Address - Street 1:725 W ALDER ST STE 20
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4099
Practice Address - Country:US
Practice Address - Phone:406-240-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT26997225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist