Provider Demographics
NPI:1184980021
Name:WALKER, GENTRY STEPHEN (DPT)
Entity type:Individual
Prefix:DR
First Name:GENTRY
Middle Name:STEPHEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 MCDOW DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2415
Mailing Address - Country:US
Mailing Address - Phone:803-366-5722
Mailing Address - Fax:
Practice Address - Street 1:831 MCDOW DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2415
Practice Address - Country:US
Practice Address - Phone:803-366-5722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist