Individual
HARRISON LOCKHART JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
Mailing address
309 W CLARK ST, MEDFORD, OR 97501-2320
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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