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JONATHON WORTH LOCKE

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1962048454

Individual Registrant:
 JONATHON WORTH LOCKE 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
UWA STATION 14  LIVINGSTON, AL 35470 US
Tel: 205-652-5483  Fax: --

Contact information for business:
1768 COUNTY ROAD 85  PRATTVILLE, AL 36067-7633 US
Tel: 334-201-4592  Fax: --

Registration Information:
NPI: 1962048454
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
AL

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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