Provider Demographics
NPI:1568719342
Name:WALKER CHIROPRACTIC CLINIC INC.
Entity Type:Organization
Organization Name:WALKER CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-235-1165
Mailing Address - Street 1:900 E 15TH ST
Mailing Address - Street 2:NONE
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-2562
Mailing Address - Country:US
Mailing Address - Phone:325-235-1165
Mailing Address - Fax:325-235-9656
Practice Address - Street 1:900 E 15TH ST
Practice Address - Street 2:NONE
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-2562
Practice Address - Country:US
Practice Address - Phone:325-235-1165
Practice Address - Fax:325-235-9656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001851701Medicaid
TX001851701Medicaid