Individual
KC LOCKLEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
608 OAK MAIN AVE, COMANCHE, OK 73529-1472
(580) 439-5712
Mailing address
PO BOX 536, COMANCHE, OK 73529-0536
(580) 439-5712
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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