Individual
ELIZABETH HUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 340-1365
Mailing address
1550 S LIBERTY DR, BLOOMINGTON, IN 47403-5167
(812) 340-1365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013222A
IN
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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