Healthcare Provider Details

I. General information

NPI: 1750090866
Provider Name (Legal Business Name): TRAVIS WALKE DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 KINGSBOROUGH SQ
CHESAPEAKE VA
23320-4944
US

IV. Provider business mailing address

1450 KEMPSVILLE RD STE 102
VIRGINIA BEACH VA
23464-7320
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-7554
  • Fax:
Mailing address:
  • Phone: 757-962-1618
  • Fax: 757-481-6175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305215506
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: