Theron Locke, DPT

Individual provider Active NPI Physical Therapist · Abbeville, AL

NPI 1003400235 · NPPES record last updated Feb 28, 2021

Key facts

NPI
1003400235
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
212 Dothan Rd
Abbeville, AL 36310-2800
Phone
(334) 585-2241
NPI assigned
Feb 28, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X AL Yes

Addresses

Primary practice location

212 Dothan Rd
Abbeville, AL 36310-2800

Mailing address

601 Whatley Dr Apt H7007
Dothan, AL 36303-2475

Other identifiers

IdentifierTypeStateIssuer
105105MedicaidAL

Electronic endpoints

TypeEndpointUseAffiliation
Other URL CASAMBA Direct

Other providers in Abbeville, AL

All providers in Abbeville, AL · Physical Therapist in Alabama

Sources for this page

Verify at the official NPI Registry.