Provider Demographics
NPI:1629470828
Name:WALKO, MATTHEW MARCUS (PT, DPT, CCS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARCUS
Last Name:WALKO
Suffix:
Gender:M
Credentials:PT, DPT, CCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 BEACON CIR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6170
Mailing Address - Country:US
Mailing Address - Phone:717-579-8294
Mailing Address - Fax:
Practice Address - Street 1:35 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1319
Practice Address - Country:US
Practice Address - Phone:717-867-6854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012868-L2251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary