Individual
MR. JEFFREY H LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3982 144TH ST W, ROSEMOUNT, MN 55068-4053
(651) 322-1650
Mailing address
3982 144TH ST W, ROSEMOUNT, MN 55068-4053
(651) 322-1650
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T340284121907
MN
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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