Provider Demographics
NPI:1811940521
Name:WALKER, TAMI SUE (L-ATC)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:SUE
Last Name:WALKER
Suffix:
Gender:F
Credentials:L-ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N OLIVETTE ST
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-3730
Mailing Address - Country:US
Mailing Address - Phone:620-654-7487
Mailing Address - Fax:
Practice Address - Street 1:1015 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-5735
Practice Address - Country:US
Practice Address - Phone:620-241-1825
Practice Address - Fax:620-241-7135
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-003902255A2300X
KS14-01933225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer