Individual
LARRY LAMONT LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
37450 SCHOOLCRAFT RD STE 110, LIVONIA, MI 48150-1000
(734) 458-4601
Mailing address
4860 HARRISON ST, WAYNE, MI 48184-2219
(313) 772-1780
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703108445
MI
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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