Provider Demographics
NPI:1083685192
Name:WALTER, THOMAS CARL (MPA-C, DPT)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CARL
Last Name:WALTER
Suffix:
Gender:M
Credentials:MPA-C, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4407
Mailing Address - Country:US
Mailing Address - Phone:717-761-5530
Mailing Address - Fax:
Practice Address - Street 1:3399 TRINDLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4407
Practice Address - Country:US
Practice Address - Phone:717-761-5530
Practice Address - Fax:717-737-7197
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058398363AM0700X
VA2305006582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist