Provider Demographics
NPI:1568595908
Name:WALTERS, SPRING KIMBERLY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SPRING
Middle Name:KIMBERLY
Last Name:WALTERS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:SPRING
Other - Middle Name:KIMBERLY
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:105 ADA D DR
Mailing Address - Street 2:
Mailing Address - City:OVETT
Mailing Address - State:MS
Mailing Address - Zip Code:39464-3754
Mailing Address - Country:US
Mailing Address - Phone:601-428-2271
Mailing Address - Fax:
Practice Address - Street 1:1220 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4355
Practice Address - Country:US
Practice Address - Phone:601-426-4119
Practice Address - Fax:601-426-4768
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT29472251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics