Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC28549 | CA |
NPI | 1194923839 |
---|---|
Provider Name | Jason E Walker |
First Address | Fresno, CA 93710-7510 |
Second Address | Fresno, CA 93710-7510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 26/06/2013 |