Individual
JUANITA LOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10051 N STATE ROAD 62, CANAAN, IN 47224-9759
(812) 717-1202
Mailing address
10051 N STATE ROAD 62, CANAAN, IN 47224-9759
(812) 717-1202
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
28152149A
IN
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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