Individual
BRIAN WESLEY LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1408 HIGH ST, BENWOOD, WV 26031-1210
(304) 617-7793
Mailing address
1408 HIGH ST, BENWOOD, WV 26031-1210
(304) 617-7793
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125553494
—
WV
05
—
1356607394
—
WV
05
—
1821206228
—
WV
Enumeration date
03/05/2024
Last updated
03/05/2024
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