Individual
MICHAEL CHARLES LOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
101 JORDAN CREEK PKWY, SUITE 12190, WEST DES MOINES, IA 50266-8181
(312) 545-3705
Mailing address
1230 37TH ST, DES MOINES, IA 50311-2707
(515) 339-1836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02379
IA
Other
Enumeration date
10/17/2006
Last updated
08/23/2014
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