Individual
MRS. ALISSA LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
655 NW COLUMBIA ST, BEND, OR 97701-3011
(541) 317-8820
Mailing address
3320 NE MANCHESTER CT, BEND, OR 97701-8360
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11765
OR
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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