Provider Demographics
NPI:1437317187
Name:WALKER PHYSICAL THERAPY & SPORTS FITNESS
Entity Type:Organization
Organization Name:WALKER PHYSICAL THERAPY & SPORTS FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:706-255-3920
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-0745
Mailing Address - Country:US
Mailing Address - Phone:706-255-3920
Mailing Address - Fax:770-783-8087
Practice Address - Street 1:182 BEN BURTON CIR
Practice Address - Street 2:SUITE 900
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622-6847
Practice Address - Country:US
Practice Address - Phone:706-255-3920
Practice Address - Fax:770-782-8087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty