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NPI Code Detail

MEDICARE: GRAICYN MCKENZIE WALKUP

MEDICARE: GRAICYN MCKENZIE WALKUP
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
1225200000XPhysical Therapy Assistant7385TN

General Provider Information

NPI Number : 1437892775
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRAICYN MCKENZIE WALKUP
Provider Business Mailing Address
First Line : 1540 BROWN AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-4351
Country : US
Telephone Number : 423-715-7412
Fax Number :
Provider Business Practice Location Address
First Line : 2255 CANDIES LN NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-2661
Country : US
Telephone Number : 423-472-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 04/14/2022

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Directions to “ GRAICYN MCKENZIE WALKUP ” Practice Location

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