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1679221584
WALLACE LOCKETT
MEDINA, OH
NPI
1679221584
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-03-10
Last Update Date
2023-06-15
Business Address
WALLACE LOCKETT
1621 MEDINA RD
MEDINA, OH 44256-5333
Phone number: 330-241-4365
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Mailing Address
WALLACE LOCKETT
17325 EUCLID AVE
CLEVELAND, OH 44112-1247
Phone number: 440-753-1444
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