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NPI Code Detail

MEDICARE: MATT WALKER DPT

MEDICARE: MATT WALKER DPT
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
1225100000XPhysical Therapist
2225100000XPhysical Therapist7260SC

General Provider Information

NPI Number : 1578986253
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATT WALKER DPT
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 439 CHANNEL RD STE 102
Second Line :
City : LAKE WYLIE
State : SC
Zip : 29710-6101
Country : US
Telephone Number : 803-746-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2014
Last Update Date : 11/22/2023

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Directions to “ MATT WALKER DPT” Practice Location

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