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Organization
LOCKE AESTHETICS LLC
Active
Organization
LOCKE AESTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LOCKE MD (OWNER)
(970) 279-4111
Entity
Organization
Contact information
Practice address
1450 E VALLEY RD, SUITE 101, BASALT, CO 81621-8304
(970) 279-4111
(970) 927-3915
Mailing address
1450 E VALLEY RD, SUITE 101, BASALT, CO 81621-8304
(970) 279-4111
(970) 927-3915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38023
CO
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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