Individual
BRADLEY ALLEN LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2793 LINEVILLE RD, GREEN BAY, WI 54313-7152
(920) 496-4700
Mailing address
2793 LINEVILLE RD, GREEN BAY, WI 54313-7152
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
55834
WI
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
55834-020
WI
Other
Enumeration date
06/23/2008
Last updated
08/05/2014
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