Individual
COLBY CHARLES LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1025 E 7TH ST, #111, BLOOMINGTON, IN 47405-7109
(812) 855-1561
Mailing address
1471 W ALLEN ST, BLOOMINGTON, IN 47403-2950
(603) 662-9886
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
ME
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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