Provider Demographics
NPI:1962048454
Name:LOCKE, JONATHON WORTH
Entity type:Individual
Prefix:
First Name:JONATHON
Middle Name:WORTH
Last Name:LOCKE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1522
Mailing Address - Country:US
Mailing Address - Phone:334-265-3199
Mailing Address - Fax:334-265-3189
Practice Address - Street 1:1636 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1522
Practice Address - Country:US
Practice Address - Phone:342-653-1993
Practice Address - Fax:334-265-3189
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist