Provider Demographics
NPI:1932507019
Name:WALKER, KOLBYANN MASHIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KOLBYANN
Middle Name:MASHIAN
Last Name:WALKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 RIVERSIDE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4494
Mailing Address - Country:US
Mailing Address - Phone:909-591-6233
Mailing Address - Fax:
Practice Address - Street 1:6040 RIVERSIDE DR
Practice Address - Street 2:SUITE C
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4494
Practice Address - Country:US
Practice Address - Phone:909-591-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC33015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor