Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1033736939 |
---|---|
Provider Name | Trisha Walters |
First Address | Walnut Creek, CA 94597-2168 |
Second Address | Walnut Creek, CA 94595-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2020 |
Last Update Date | 05/11/2020 |