Individual
MISS TINA MARIE LOUCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6294 FULFORD HILL RD, BATH, NY 14810-8156
(607) 794-2998
Mailing address
6294 FULFORD HILL RD, BATH, NY 14810-8156
(607) 794-2998
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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