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NPI 1104021807

NPI 1104021807 : RHEA TIFFANY WALKER P.T. : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1104021807
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    Entity Type          |    Individual 
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    Provider Name        |    RHEA TIFFANY WALKER P.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/20/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3145 S CANFIELD AVE APT 13 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90034-4352
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    Country              |    US
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    Telephone            |    310-558-8085
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3145 S CANFIELD AVE APT 13 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90034-4352
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    250635
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    License Number State |    CA
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