Provider Demographics
NPI:1477277408
Name:WALKER, JULIANNE BETSILL (ATC, LAT, MS)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:BETSILL
Last Name:WALKER
Suffix:
Gender:F
Credentials:ATC, LAT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4665 MADELINE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8335
Mailing Address - Country:US
Mailing Address - Phone:704-740-0780
Mailing Address - Fax:
Practice Address - Street 1:2911 NEVADA BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6434
Practice Address - Country:US
Practice Address - Phone:704-740-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer