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Individual

ALEXIS W LOCKYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
103 N MAIN ST, STE 300, GREENVILLE, SC 29601-2796
(864) 528-5753
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4446
SC
225100000X
Physical Therapist
9925
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
354105600
DEPT. OF LABOR NUMBER
SC
01
650026189
MEDICARE RAILROAD NUMBER
SC
01
7796338
AETNA
SC
01
943423122
PROVIDER NUMBER
SC
01
C5655
MEDCOST NUMBER
SC
Enumeration date
07/29/2006
Last updated
11/09/2015
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