Provider Demographics
NPI:1053481572
Name:WALTER, GEORGE J JR (PT)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:J
Last Name:WALTER
Suffix:JR
Gender:M
Credentials:PT
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Mailing Address - Street 1:100 BREWSTER BLVD.
Mailing Address - Street 2:NAVAL HOSPITAL, ATTN MEDICAL STAFF SERVICES
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2538
Mailing Address - Country:US
Mailing Address - Phone:910-450-4136
Mailing Address - Fax:910-450-4558
Practice Address - Street 1:100 BREWSTER BLVD.
Practice Address - Street 2:NAVAL HOSPITAL, ATTN MEDICAL STAFF SERVICES
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-2538
Practice Address - Country:US
Practice Address - Phone:910-450-4136
Practice Address - Fax:910-450-4558
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2009-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist