Individual
MELISSA MARIE LOCKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
601 BUTLER ST, DUNMORE, PA 18512-2815
(570) 362-3373
(570) 344-4090
Mailing address
601 BUTLER ST, DUNMORE, PA 18512-2815
(570) 362-3373
(570) 344-4090
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OC003647L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018636260001
—
PA
Enumeration date
04/03/2007
Last updated
07/09/2007
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