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General NPI Number Information
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NPI Number | 1255494191
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Entity Type | Organization
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Legal Business Name | LOCKE CHIROPRACTIC AND REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 135 GREENFORD PL
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City | JACKSONVILLE
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State | NC
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Zip | 28540-5744
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Country | US
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Telephone | 864-237-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 135 GREENFORD PL
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City | JACKSONVILLE
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State | NC
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Zip | 28540-5744
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Country | US
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Telephone | 864-237-2041
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JONATHAN GEORGE LOCKE
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Credential | DC
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Telephone | 864-237-2041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3457
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License Number State | NC
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