Individual
STEPHEN LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-3011
(912) 547-7317
Mailing address
817 N AINSWORTH ST, PORTLAND, OR 97217-2201
(912) 547-7317
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
04/19/2021
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