Individual
MISS MELISSA LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1701 S 11TH ST, KALAMAZOO, MI 49009-1775
(269) 375-2020
(269) 375-7990
Mailing address
1701 S 11TH ST, KALAMAZOO, MI 49009-1775
(269) 375-2020
(269) 375-7990
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003548
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306893805
—
MI
Enumeration date
11/05/2013
Last updated
11/05/2013
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