Individual
LOCKA LADENA KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 N 5TH AVE, MADILL, OK 73446-1203
(580) 795-3301
(580) 795-7307
Mailing address
PO BOX 831, MADILL, OK 73446-0831
(580) 795-3301
(580) 795-7307
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
45
OK
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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