Healthcare Provider Details

I. General information

NPI: 1679408777
Provider Name (Legal Business Name): LARA CLAGETT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 US HIGHWAY 93 N
STEVENSVILLE MT
59870-6425
US

IV. Provider business mailing address

913 MIDDLE BURNT FORK RD
STEVENSVILLE MT
59870-6643
US

V. Phone/Fax

Practice location:
  • Phone: 406-370-0764
  • Fax:
Mailing address:
  • Phone: 406-370-0764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLMT-LMT-LIC-32162
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: