Provider Demographics
NPI:1821764028
Name:WALKER, LINDIE M (PT)
Entity Type:Individual
Prefix:
First Name:LINDIE
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-8606
Mailing Address - Country:US
Mailing Address - Phone:501-286-6059
Mailing Address - Fax:501-286-6061
Practice Address - Street 1:100 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-8606
Practice Address - Country:US
Practice Address - Phone:501-286-6059
Practice Address - Fax:501-286-6061
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT5008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist