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NPI Code Detail

MEDICARE: NICHOLAS W LOCKHART PT

MEDICARE: NICHOLAS W LOCKHART PT
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
1225100000XPhysical Therapist17769-24WI

General Provider Information

NPI Number : 1922924109
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS W LOCKHART PT
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 5000 MEMORIAL DR
Second Line :
City : TWO RIVERS
State : WI
Zip : 54241-3900
Country : US
Telephone Number : 920-794-5376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/24/2026

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Directions to “ NICHOLAS W LOCKHART PT” Practice Location

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