Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIRO10022 | GA |
NPI | 1891299970 |
---|---|
Provider Name | Zach Walker |
First Address | Smyrna, GA 30080-7668 |
Second Address | Ringgold, GA 30736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 22/03/2018 |