MEDICARE: MRS. RHONDA LANETTE WALKER MPT

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	225100000X	Physical Therapist	5501011822	MI

General Provider Information

NPI Number	:	1376785253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RHONDA LANETTE WALKER MPT

Provider Business Mailing Address
First Line	:	33200 W 14 MILE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3563
Country	:	US
Telephone Number	:	248-538-7607
Fax Number	:	248-538-7623

Provider Business Practice Location Address
First Line	:	33200 W 14 MILE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3563
Country	:	US
Telephone Number	:	248-538-7607
Fax Number	:	248-538-7623

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

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	03/24/2009

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