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Individual

ANTHONY LOCKRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
645 PRIMROSE LN, MATTESON, IL 60443-1762
(708) 283-1147
(773) 731-4761
Mailing address
645 PRIMROSE LN, MATTESON, IL 60443-1762
(708) 283-1147
(773) 731-4761

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051037955
IL

Other

Enumeration date
01/15/2012
Last updated
01/15/2012
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