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General NPI Number Information
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NPI Number | 1215159835
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Entity Type | Individual
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Provider Name | JULIANNA MARIE WALTERS PT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 2414 W FRANK AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3521
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Country | US
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Telephone | 639-699-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 1281 OLD HIGHWAY 59
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City | LUFKIN
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State | TX
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Zip | 75904-1583
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Country | US
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Telephone | 936-639-1428
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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 | 1158703
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016229
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT002327
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License Number State | WV
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