Provider Demographics
NPI:1427117316
Name:LOCKERT, JOYCE D (DPT, OCS, SCS, ATC)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:D
Last Name:LOCKERT
Suffix:
Gender:F
Credentials:DPT, OCS, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-0905
Mailing Address - Country:US
Mailing Address - Phone:802-748-8141
Mailing Address - Fax:802-748-4098
Practice Address - Street 1:245 NORTH STREET
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MI
Practice Address - Zip Code:02180
Practice Address - Country:US
Practice Address - Phone:781-438-7221
Practice Address - Fax:781-438-7208
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA043087537OtherPRIVATE
MAY66977OtherBLUE CROSS BLUE SHIELD
MA616931OtherHARVARD PILGRIM HEALTH
MA470209OtherTUFTS HEALTH PLAN
MAY68346Medicare ID - Type Unspecified