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Individual

MRS. GENIA RENAE LOCKLEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFTS

Contact information

Practice address
407 W 3RD ST, PEMBROKE, NC 28372-7977
(910) 521-5600
(910) 521-1906
Mailing address
407 W 3RD ST, PO BOX 2639, PEMBROKE, NC 28372-7977
(910) 521-5600
(910) 521-1906

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
CFTS 7713
NC

Other

Enumeration date
11/20/2012
Last updated
07/14/2014
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