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General NPI Number Information
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NPI Number | 1104063494
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Entity Type | Individual
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Provider Name | DEBRA J WALKER LMT
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Gender | Female
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 635 SOUTHPOINTE CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3877
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Country | US
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Telephone | 719-205-5114
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Fax | 719-475-1880
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Provider Business Mailing Address
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Address Line | 1408 CRESTONE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80905-7325
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Country | US
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Telephone | 719-205-5114
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Fax | 719-475-1880
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 713083
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License Number State | CO
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