Individual
TANYA L LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
2800 LIVERNOIS RD STE 500, TROY, MI 48083-1219
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704309664
MI
Other
Enumeration date
10/15/2020
Last updated
10/16/2020
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