Provider Demographics
NPI:1821210634
Name:WALTON, WENDY ANNE (PTA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ANNE
Last Name:WALTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ANNE
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1201 BLEACHERY BLVD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8313
Mailing Address - Country:US
Mailing Address - Phone:828-277-5763
Mailing Address - Fax:828-277-5764
Practice Address - Street 1:1201 BLEACHERY BLVD
Practice Address - Street 2:SUITE # 201
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8313
Practice Address - Country:US
Practice Address - Phone:828-277-5763
Practice Address - Fax:828-277-5764
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6095853225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant