Individual
MARK ANTHONY LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6432 CAMBRIDGE DR, HARRISBURG, NC 28075-9503
(816) 213-4917
Mailing address
6432 CAMBRIDGE DR, HARRISBURG, NC 28075-9503
(816) 213-4917
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
000035030777
NC
Other
Enumeration date
01/25/2025
Last updated
01/25/2025
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