Provider Demographics
NPI:1881612588
Name:WALKERWICZ, JOHN DAVID (MPT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DAVID
Last Name:WALKERWICZ
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3528
Mailing Address - Country:US
Mailing Address - Phone:828-698-0017
Mailing Address - Fax:828-692-9450
Practice Address - Street 1:800 FLEMING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3528
Practice Address - Country:US
Practice Address - Phone:828-698-0017
Practice Address - Fax:828-692-9450
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC841139OtherUHC ACN MPN
NC8277714OtherUHC ACN MPN
NC079KAOtherBCBS
NC6606556OtherGHI
NC6606556OtherGHI