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Individual

MRS. MARTHA C. LOCKWOOD

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
101 N 2ND ST, RATON, NM 87740-3803
(505) 445-7090
Mailing address
PO BOX 930, RED RIVER, NM 87558-0930
(505) 754-3155
(505) 754-2894

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTR/L 975
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T6366
NM
Enumeration date
04/26/2006
Last updated
07/09/2007
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