Individual
KEISHA BERNICE LOCKHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1332 SOUTHERN DR, STATESBORO, GA 30460-1360
(912) 478-4636
Mailing address
483 MCWILLIAMS AVE SE, ATLANTA, GA 30316-1729
(832) 544-5647
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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