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General NPI Number Information
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NPI Number | 1780132159
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Entity Type | Individual
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Provider Name | ERIC WALZ DPT
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Gender | Male
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 303 N GLENOAKS BLVD STE 200
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City | BURBANK
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State | CA
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Zip | 91502
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Country | US
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Telephone | 818-823-6621
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Fax | 818-356-4380
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Provider Business Mailing Address
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Address Line | 303 N GLENOAKS BLVD STE 200
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City | BURBANK
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State | CA
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Zip | 91502-1118
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Country | US
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Telephone | 818-823-6621
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Fax | 818-483-2369
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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 | 291990
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License Number State | CA
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