Individual
GREGORY A LOUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 408-2203
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704258243
MI
Other
Enumeration date
09/30/2009
Last updated
12/16/2022
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