Healthcare Provider Details

I. General information

NPI: 1316174485
Provider Name (Legal Business Name): JAMES WALKER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W VISALIA RD
EXETER CA
93221-1019
US

IV. Provider business mailing address

1121 W HOWARD AVE
VISALIA CA
93277-4607
US

V. Phone/Fax

Practice location:
  • Phone: 559-592-7117
  • Fax: 559-592-7112
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8898
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT 5247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: