Provider Demographics
NPI:1346672433
Name:WALKER, MARTHA LYNN (PT)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1015 W 47TH ST
Mailing Address - Street 2:OLD DOMINION UNIVERSITY
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23529-0001
Mailing Address - Country:US
Mailing Address - Phone:757-683-3309
Mailing Address - Fax:757-683-7050
Practice Address - Street 1:1015 W 47TH ST
Practice Address - Street 2:OLD DOMINION UNIVERSITY
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23529-0001
Practice Address - Country:US
Practice Address - Phone:757-683-3309
Practice Address - Fax:757-683-7050
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305002365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist