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Organization

MANOR AVENUE CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW J LOCKSHAW III DO (DO)
(330) 755-3233
Entity
Organization

Contact information

Practice address
296 E MANOR AVE, STRUTHERS, OH 44471-1545
(330) 755-3233
(330) 755-4511
Mailing address
296 E MANOR AVE, STRUTHERS, OH 44471-1545
(330) 755-3233
(330) 755-4511

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0795564
OH
Enumeration date
12/01/2005
Last updated
08/22/2020
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