Individual
GLORIA LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-OPA
Contact information
Practice address
140 24TH ST S, WISCONSIN RAPIDS, WI 54494-1906
(715) 424-1881
(715) 423-1602
Mailing address
140 24TH ST S, PO BOX 8005, WISCONSIN RAPIDS, WI 54494-1906
(715) 424-1881
(715) 423-1602
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
51120-030
WI
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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