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NPI Code Detail

MEDICARE: JENNIFER E WALKER DC

MEDICARE: JENNIFER E WALKER DC
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
1111N00000XChiropractor0104556935VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00319591OTHERMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2188918OTHERANTHEM

General Provider Information

NPI Number : 1649200130
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER E WALKER DC
Provider Business Mailing Address
First Line : 2110 CAROLINA AVE SW
Second Line :
City : ROANOKE
State : VA
Zip : 24014-1738
Country : US
Telephone Number : 540-343-0055
Fax Number : 540-343-0056
Provider Business Practice Location Address
First Line : 2522 COLONIAL AVE SW
Second Line :
City : ROANOKE
State : VA
Zip : 24015-3121
Country : US
Telephone Number : 540-343-0055
Fax Number : 540-627-5055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 11/11/2024

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