Provider Demographics
NPI:1851620603
Name:WALKER, AMBER SKY (PTA)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:SKY
Last Name:WALKER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 W KENT STATE ROAD 256
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-7451
Mailing Address - Country:US
Mailing Address - Phone:812-599-0050
Mailing Address - Fax:
Practice Address - Street 1:950 CROSS AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-2002
Practice Address - Country:US
Practice Address - Phone:812-273-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002688A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant