Healthcare Provider Details

I. General information

NPI: 1427241348
Provider Name (Legal Business Name): JOHN C WALKER MPT, CSCS,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9219 E HIDDEN SPUR TRL STE 100
SCOTTSDALE AZ
85255-6708
US

IV. Provider business mailing address

PO BOX 80217
PHOENIX AZ
85060-0217
US

V. Phone/Fax

Practice location:
  • Phone: 602-648-5444
  • Fax: 602-772-3801
Mailing address:
  • Phone: 602-385-2115
  • Fax: 480-418-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number01723
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: