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Individual

MRS. RUBY JANE LOCKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
836 DAVIE AVE, STATESVILLE, NC 28677-5311
(828) 381-0165
Mailing address
2001 VAN HAVEN DR, STATESVILLE, NC 28625-4342

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5127
NC
225400000X
Rehabilitation Practitioner
A5127
NC

Other

Enumeration date
04/02/2019
Last updated
04/02/2019
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