Individual
BEAU STEPHEN LOCKMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1673 W SHORELINE DR STE 230, BOISE, ID 83702-6752
(208) 343-4700
(208) 343-4706
Mailing address
645 E STATE ST STE 101, EAGLE, ID 83616-5915
(208) 939-9594
(208) 939-9828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7235
ID
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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