Provider Demographics
NPI:1023425733
Name:WALKER, ERIKA DEBRO (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:DEBRO
Last Name:WALKER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2768 ABBY BROOKE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8151
Mailing Address - Country:US
Mailing Address - Phone:678-315-5318
Mailing Address - Fax:
Practice Address - Street 1:2768 ABBY BROOKE
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8151
Practice Address - Country:US
Practice Address - Phone:678-315-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0021702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer