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1578830956
CAROL A LOUCKS
PROVO, UT
NPI
1578830956
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 202205-4405)
Enumeration Date
2011-11-29
Last Update Date
2011-11-29
Business Address
-- CAROL A LOUCKS APRN
1629 W 1170 N
PROVO, UT 84604-2923
Phone number: 801-472-6111
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Mailing Address
-- CAROL A LOUCKS APRN
1629 W 1170 N
PROVO, UT 84604-2923
Phone number: 801-472-6111
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