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1790077105
TRAVIS ALLEN WAYNE LOCKNER
BRISTOL, TN
NPI
1790077105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-05-04
Last Update Date
2011-05-04
Business Address
-- TRAVIS ALLEN WAYNE LOCKNER
26 MIDWAY ST
BRISTOL, TN 37620-1706
Phone number: 423-989-4500
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Mailing Address
-- TRAVIS ALLEN WAYNE LOCKNER
1167 SPRATLIN PARK DR
GRAY, TN 37615-6205
Phone number: 423-467-3600
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