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General NPI Number Information
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NPI Number | 1265862205
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Entity Type | Individual
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Provider Name | WILLIAM WALSH P.T.
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Gender | Male
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 14239 W BELL RD SUITE 219
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City | SURPRISE
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State | AZ
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Zip | 85374-2469
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Country | US
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Telephone | 623-293-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 5350 W BELL RD SUITE C-122 #210
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City | GLENDALE
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State | AZ
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Zip | 85308-3906
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Country | US
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Telephone | 623-293-8555
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 6351
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License Number State | AZ
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