Most Relevant Information
Provider Data
| NPI Number: | 1003697160 |
| Provider Name: | MADISON LOCKE RDN, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/13/2023 |
| Last Updated: | 10/13/2023 |
Provider Practice Location
171 ASHLEY AVE
CHARLESTON
SC
294258908
Practice Location Phone/Fax
| Phone: | 8437921414 |
| Fax: |
Provider Mailing Location
171 ASHLEY AVE
CHARLESTON
SC
294258908
Provider Mailing Phone/Fax
| Phone: | 8437921414 |
| Fax: |