Provider Demographics
NPI:1790024925
Name:WALKER, MYLES MILTON JR
Entity Type:Individual
Prefix:MR
First Name:MYLES
Middle Name:MILTON
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 WALLACE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5140
Mailing Address - Country:US
Mailing Address - Phone:603-289-1468
Mailing Address - Fax:603-472-6957
Practice Address - Street 1:164 WALLACE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5140
Practice Address - Country:US
Practice Address - Phone:603-289-1468
Practice Address - Fax:603-472-6957
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHH517332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment