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Individual
BRADLEY ALLEN LOCKE
Active
Individual
BRADLEY ALLEN LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
55834
WI
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
55834-020
WI
Other
Enumeration date
06/23/2008
Last updated
08/05/2014
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