Provider Demographics
NPI:1558391151
Name:WALKER, JAMES E (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:WALKER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 760688
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-0004
Mailing Address - Country:US
Mailing Address - Phone:781-662-7832
Mailing Address - Fax:
Practice Address - Street 1:489 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-2349
Practice Address - Country:US
Practice Address - Phone:781-760-5057
Practice Address - Fax:781-393-2352
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2255A2300XOtherATHLETIC TRAINER