Individual
MARY SHORTER LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4380 NW 36TH ST, LAUDERDALE LAKES, FL 33319-5539
(954) 873-9606
Mailing address
4380 NW 36TH ST, LAUDERDALE LAKES, FL 33319-5539
(954) 873-9606
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/25/2017
Last updated
07/21/2022
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