CAROL A LOUCKS

PROVO, UT
NPI1578830956
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  202205-4405)
Enumeration Date2011-11-29
Last Update Date2011-11-29
Business Address
-- CAROL A LOUCKS APRN
1629 W 1170 N
PROVO, UT 84604-2923
Phone number: 801-472-6111
Mailing Address
-- CAROL A LOUCKS APRN
1629 W 1170 N
PROVO, UT 84604-2923
Phone number: 801-472-6111