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General NPI Number Information
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NPI Number | 1750090866
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Entity Type | Individual
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Provider Name | TRAVIS WILLIAM WALKE DPT, PT
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Gender | Male
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 637 KINGSBOROUGH SQ
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4944
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Country | US
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Telephone | 757-547-7554
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 KEMPSVILLE RD STE 102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-7320
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Country | US
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Telephone | 757-962-1618
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Fax | 757-481-6175
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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 | 2305215506
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License Number State | VA
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