MEDICARE: MARK ORLO WALKER PT

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	2251G0304X	Geriatric Physical Therapist	7973876-2401	UT

General Provider Information

NPI Number	:	1467746073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ORLO WALKER PT

Provider Business Mailing Address
First Line	:	744 W 550 S
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84058-6000
Country	:	US
Telephone Number	:	801-885-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 E 1300 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-1949
Country	:	US
Telephone Number	:	801-487-5865
Fax Number	:

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

Provider Enumeration Date	:	06/01/2011
Last Update Date	:	06/01/2011

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Directions to “ MARK ORLO WALKER PT” Practice Location

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