Individual
THERON LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
212 DOTHAN RD, ABBEVILLE, AL 36310-2800
(334) 585-2241
Mailing address
601 WHATLEY DR APT H7007, DOTHAN, AL 36303-2475
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105105
—
AL
Enumeration date
02/28/2021
Last updated
02/28/2021
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