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General NPI Number Information
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NPI Number | 1801526157
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Entity Type | Individual
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Provider Name | GABRIELLA LOCKHART
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Gender | Female
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 50 JOACHIM DR
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City | GULF BREEZE
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State | FL
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Zip | 32561-4474
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Country | US
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Telephone | 850-749-5035
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Fax |
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Provider Business Mailing Address
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Address Line | 1518 BONEFISH CT
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City | GULF BREEZE
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State | FL
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Zip | 32563-8973
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Country | US
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Telephone | 731-343-2969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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