Provider Demographics
NPI:1811126451
Name:LOCKWOOD, DEBORAH URIE (PT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:URIE
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4842
Mailing Address - Country:US
Mailing Address - Phone:307-778-8997
Mailing Address - Fax:
Practice Address - Street 1:1330 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4842
Practice Address - Country:US
Practice Address - Phone:307-778-8997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1157225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist