Individual
MR. JIM NESTER LOUKOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20216 E. CONESTOGAO DR., MAYER, AZ 86333
(928) 638-9192
Mailing address
440 N WASHINGTON AVE, PRESCOTT, AZ 86301-2642
(928) 443-1991
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
900145
AZ
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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