Individual provider · NPI-1
Theron Locke, DPT
Physical Therapist · Abbeville, AL
NPI number1003400235
StatusActive
Last updated in NPPESFeb 28, 2021
Details
- NPI
- 1003400235
- Entity type
- Individual (NPI-1)
- Name
- Theron Locke
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 28, 2021
- Certification date
- Feb 28, 2021
- Last updated
- Feb 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | AL | Yes |
Practice location
212 Dothan RdAbbeville, AL 36310-2800
Phone 334-585-2241
Mailing address
601 Whatley Dr Apt H7007Dothan, AL 36303-2475
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