Provider Demographics
NPI:1588615967
Name:WALKER, PRESTON ALMAND JR (LPT)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:ALMAND
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16406 HWY 17
Mailing Address - Street 2:SUITE 9
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443
Mailing Address - Country:US
Mailing Address - Phone:910-270-6026
Mailing Address - Fax:910-270-6028
Practice Address - Street 1:16406 HWY 17
Practice Address - Street 2:STE 9
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443
Practice Address - Country:US
Practice Address - Phone:910-270-6026
Practice Address - Fax:910-270-6028
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC079VROtherBCBSNC
NC2507990AMedicare PIN