| NPI | 1942770755 |
|---|---|
| Former Name | MADISON CHRISTINA LOCKABY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT003071) |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2018-12-05 |