Provider Demographics
NPI:1851486690
Name:WALKER, JAMES COREY (DC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:COREY
Last Name:WALKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GREENLAW BLVD
Mailing Address - Street 2:CLAY COUNTY CHIROPRACTIC INC
Mailing Address - City:FLORA
Mailing Address - State:IL
Mailing Address - Zip Code:62839-1300
Mailing Address - Country:US
Mailing Address - Phone:618-662-4100
Mailing Address - Fax:618-662-8751
Practice Address - Street 1:11 GREENLAW BLVD
Practice Address - Street 2:CLAY COUNTY CHIROPRACTIC INC
Practice Address - City:FLORA
Practice Address - State:IL
Practice Address - Zip Code:62839-1300
Practice Address - Country:US
Practice Address - Phone:618-662-4100
Practice Address - Fax:618-662-8751
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1160233OtherCAQH