Provider Demographics
NPI:1033664982
Name:LOCKMAN, JASON (DPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LOCKMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LINDEN OAKS STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2841
Mailing Address - Country:US
Mailing Address - Phone:585-264-9440
Mailing Address - Fax:
Practice Address - Street 1:4601 WHITESBURG DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1676
Practice Address - Country:US
Practice Address - Phone:256-883-1734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31491225100000X
NY041254225100000X
ALPTH10100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist