Provider Demographics
NPI:1295817658
Name:LOCKWOOD, RYAN T (PT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:T
Last Name:LOCKWOOD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9977 WORMAN DR
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-7558
Mailing Address - Country:US
Mailing Address - Phone:540-368-1400
Mailing Address - Fax:540-368-0055
Practice Address - Street 1:2300 CHARLES ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3346
Practice Address - Country:US
Practice Address - Phone:540-368-1400
Practice Address - Fax:540-368-0055
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006730225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics