Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A00589 | KY |
NPI | 1013114271 |
---|---|
Provider Name | Mr. Barry Walker |
First Address | Cadiz, KY 42211-9605 |
Second Address | Cadiz, KY 42211-9605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |