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1770278574
LUCAS BOLT
INDIANAPOLIS, IN
NPI
1770278574
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner Adult Health
(Licence: IN 71013689A)
Enumeration Date
2023-04-07
Last Update Date
2023-04-10
Business Address
LUCAS BOLT NP
5255 E STOP 11 RD STE 200
INDIANAPOLIS, IN 46237-6341
Phone number: 317-528-1212
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Mailing Address
LUCAS BOLT NP
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800
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