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1093156481
SHANNON LEE LUCZAK
SOUTH BEND, IN
NPI
1093156481
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367A00000X Advanced Practice Midwife
Enumeration Date
2013-07-12
Last Update Date
2019-03-04
Business Address
MRS. SHANNON LEE LUCZAK APN
515 N LAFAYETTE BLVD
SOUTH BEND, IN 46601-1003
Phone number: 574-232-2037
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Mailing Address
MRS. SHANNON LEE LUCZAK APN
1531 S HALSTED ST UNIT 301
CHICAGO, IL 60607-5135
Phone number: 989-482-7696
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