Provider Demographics
NPI:1710084462
Name:RAMKE, WALTER ALLEN JR (RT)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:ALLEN
Last Name:RAMKE
Suffix:JR
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 GLENWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-7732
Mailing Address - Country:US
Mailing Address - Phone:337-893-3385
Mailing Address - Fax:337-412-6875
Practice Address - Street 1:9015 GLENWOOD BLVD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-7732
Practice Address - Country:US
Practice Address - Phone:337-893-3385
Practice Address - Fax:337-412-6875
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist