MEDICARE: MS. JOYCE L BRIDGES-LOCKETT OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	6194	NC

General Provider Information

NPI Number	:	1649501925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE L BRIDGES-LOCKETT OTR

Provider Business Mailing Address
First Line	:	5010 ELIZABETH RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-4537
Country	:	US
Telephone Number	:	704-564-5973
Fax Number	:

Provider Business Practice Location Address
First Line	:	5010 ELIZABETH RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-4537
Country	:	US
Telephone Number	:	704-564-5973
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2010
Last Update Date	:	03/11/2011

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