Provider Demographics
NPI:1346483989
Name:WALKER, CRESLEY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:CRESLEY
Middle Name:WAYNE
Last Name:WALKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HACKNEY LN
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-6052
Mailing Address - Country:US
Mailing Address - Phone:219-464-8463
Mailing Address - Fax:
Practice Address - Street 1:105 HACKNEY LN
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-6052
Practice Address - Country:US
Practice Address - Phone:219-464-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000777A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor