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Individual

MR. RYAN MICHAEL LOCKLEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
113 BRIGHT LEAF LOOP, SUMMERVILLE, SC 29486-8270
(843) 870-9309
Mailing address
113 BRIGHT LEAF LOOP, SUMMERVILLE, SC 29486-8270
(843) 870-9309

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5689
SC

Other

Enumeration date
10/05/2021
Last updated
10/05/2021
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