Healthcare Provider Details

I. General information

NPI: 1821970278
Provider Name (Legal Business Name): ALEXIS LOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 W NORTH ST
JACKSON MI
49202-3313
US

IV. Provider business mailing address

10600 GROVER RD
READING MI
49274-9561
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-3250
  • Fax:
Mailing address:
  • Phone: 517-677-0105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: