Organization
PHYSIOM ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE A LOCKWOOD MD (OFFICER)
(970) 377-9555
Entity
Organization
Contact information
Practice address
1300 OAKRIDGE DR, #130, FORT COLLINS, CO 80525-5564
(970) 377-9555
(970) 377-9559
Mailing address
1300 OAKRIDGE DR, #130, FORT COLLINS, CO 80525-5564
(970) 377-9555
(970) 377-9559
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40137724
—
CO
05
—
445119
—
AZ
Enumeration date
10/20/2006
Last updated
06/23/2011
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