Provider Demographics
NPI:1053466482
Name:WALKER, LYNETTA (PT)
Entity Type:Individual
Prefix:MS
First Name:LYNETTA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 JAMES LN
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9785
Mailing Address - Country:US
Mailing Address - Phone:724-444-3075
Mailing Address - Fax:
Practice Address - Street 1:400 W CULVERT ST
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-1580
Practice Address - Country:US
Practice Address - Phone:724-452-1603
Practice Address - Fax:724-631-0199
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 002682 L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist