Individual
BRENT LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1726 MAPLELEAF DR, WYLIE, TX 75098-8166
(214) 471-8936
Mailing address
1726 MAPLELEAF DR, WYLIE, TX 75098-8166
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1162941
TX
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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