Healthcare Provider Details
I. General information
NPI: 1932174810
Provider Name (Legal Business Name): JEFFREY DAVID WALKER D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/22/2006
Last Update Date: 02/28/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2803 MEDICAL CAMPUS DR
GOLDSBORO, NC 27531 NC
27530
US
IV. Provider business mailing address
102 SHADOWBROOK DR
TUNKHANNOCK PA
18657-6860
US
V. Phone/Fax
- Phone: 919-722-8310
- Fax:
- Phone: 717-368-7353
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 017085 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: