LUCAS BOLT

INDIANAPOLIS, IN
NPI1770278574
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: IN  71013689A)
Enumeration Date2023-04-07
Last Update Date2023-04-10
Business Address
LUCAS BOLT NP
5255 E STOP 11 RD STE 200
INDIANAPOLIS, IN 46237-6341
Phone number: 317-528-1212
Mailing Address
LUCAS BOLT NP
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800