MEDICARE: DR. ALJOESON WALKER II PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	016694	GA

General Provider Information

NPI Number	:	1053091231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALJOESON WALKER II PT, DPT

Provider Business Mailing Address
First Line	:	1720 PEACHTREE ST NW STE 422
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2448
Country	:	US
Telephone Number	:	404-733-1936
Fax Number	:	404-733-1940

Provider Business Practice Location Address
First Line	:	1720 PEACHTREE ST NW STE 422
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2448
Country	:	US
Telephone Number	:	404-733-1936
Fax Number	:	404-733-1940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2023
Last Update Date	:	07/21/2023

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