Individual
GABRIELLE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9421 MARBARRY DR, FAIRVIEW HEIGHTS, IL 62208-1146
(618) 550-8610
Mailing address
9421 MARBARRY DR, FAIRVIEW HEIGHTS, IL 62208-1146
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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