Individual
KELSEY LOUISE LOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
915 CARL ALLEN ST, MOUNT VERNON, MO 65712-1612
(417) 466-2183
Mailing address
915 CARL ALLEN ST, MOUNT VERNON, MO 65712-1612
(417) 466-2183
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2013025688
MO
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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