Individual
CAROL LOUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5570 MAIN ST, WILLIAMSVILLE, NY 14221-5477
(716) 541-9111
Mailing address
920 MOHAWK ST, 127 BUILDING 4, LEWISTON, NY 14092-1481
(716) 754-2616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003996-1
NY
Other
Enumeration date
01/28/2013
Last updated
01/29/2013
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