Healthcare Provider Details

I. General information

NPI: 1063408961
Provider Name (Legal Business Name): DAVID ALLEN WALSH R.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 SOUTH DONAHUE DRIVE PLAINSMAN PARK PHYSICAL THERAPY
AUBURN AL
36849-0001
US

IV. Provider business mailing address

349 SOUTH DONAHUE DRIVE PLAINSMAN PARK PHYSICAL THERAPY
AUBURN AL
36849-0001
US

V. Phone/Fax

Practice location:
  • Phone: 334-844-9919
  • Fax: 334-844-8139
Mailing address:
  • Phone: 334-844-9919
  • Fax: 334-844-8139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPTH3066
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: