RUSSELL LAMAR LOCKE

TITUSVILLE, FL
NPI1891256277
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: FL  OTA10650)
Enumeration Date2019-03-27
Last Update Date2019-03-27
Business Address
RUSSELL LAMAR LOCKE Cota/L
1705 JESS PARRISH CT
TITUSVILLE, FL 32796-2158
Phone number: 321-269-5720
Mailing Address
RUSSELL LAMAR LOCKE Cota/L
6511 JUNE DR
COCOA, FL 32926-2326
Phone number: 321-333-2068
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