Healthcare Provider Details

I. General information

NPI: 1104883289
Provider Name (Legal Business Name): DANIEL J WALKER MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 ARRANDALE BLVD
EXTON PA
19341-2503
US

IV. Provider business mailing address

565 WINTURFORD DR
WEST CHESTER PA
19382-8171
US

V. Phone/Fax

Practice location:
  • Phone: 610-594-9333
  • Fax: 610-594-9246
Mailing address:
  • Phone: 610-793-3942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011253L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: