MEDICARE: MICHAEL WALKER LPTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA13214	FL

General Provider Information

NPI Number	:	1194250225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL WALKER LPTA

Provider Business Mailing Address
First Line	:	4801 NE 13TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-2103
Country	:	US
Telephone Number	:	352-812-4457
Fax Number	:	352-237-0498

Provider Business Practice Location Address
First Line	:	4801 NE 13TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-2103
Country	:	US
Telephone Number	:	352-812-4457
Fax Number	:	352-237-0498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	04/26/2017

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Directions to “ MICHAEL WALKER LPTA” Practice Location

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