Provider Demographics
NPI:1508932526
Name:WALKO, THOMAS J (DC CCN MS DCBCN)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:WALKO
Suffix:
Gender:M
Credentials:DC CCN MS DCBCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 DAVIS STRAITS
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-3907
Mailing Address - Country:US
Mailing Address - Phone:508-540-4000
Mailing Address - Fax:508-540-5151
Practice Address - Street 1:69 DAVIS STRAITS
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-3907
Practice Address - Country:US
Practice Address - Phone:508-540-4000
Practice Address - Fax:508-540-5151
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
W67593Medicare UPIN
436259Medicare ID - Type Unspecified