Individual
MARY JO LAUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, CNOR, RNFA
Contact information
Practice address
5255 E STOP 11 RD, INDIANAPOLIS, IN 46237-6340
(317) 851-2331
Mailing address
635 BOULDER RD, INDIANAPOLIS, IN 46217-3907
(317) 783-1770
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
28063378A
IN
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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