Healthcare Provider Details

I. General information

NPI: 1457214793
Provider Name (Legal Business Name): REBECCA WALKER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 IRWIN SIMPSON RD BLDG 2
MASON OH
45040-8107
US

IV. Provider business mailing address

986 TIBBETTS WICK RD BLDG 2
GIRARD OH
44420-1138
US

V. Phone/Fax

Practice location:
  • Phone: 330-919-9575
  • Fax: 330-919-9576
Mailing address:
  • Phone: 330-919-9575
  • Fax: 330-919-9576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT007704
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: