Provider Demographics
NPI:1104017284
Name:WALKER, DEBORAH LYNN (MPT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3294 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2426
Mailing Address - Country:US
Mailing Address - Phone:562-988-3570
Mailing Address - Fax:562-988-3671
Practice Address - Street 1:3294 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2426
Practice Address - Country:US
Practice Address - Phone:562-988-3570
Practice Address - Fax:562-988-3671
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist