MEDICARE: CARLENE WALKER PT

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	2251P0200X	Pediatric Physical Therapist	2305208552	VA

General Provider Information

NPI Number	:	1700202454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLENE WALKER PT

Provider Business Mailing Address
First Line	:	100 CARPENTER DR STE 140
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4464
Country	:	US
Telephone Number	:	703-707-9060
Fax Number	:	703-707-9022

Provider Business Practice Location Address
First Line	:	100 CARPENTER DR STE 140
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4464
Country	:	US
Telephone Number	:	703-707-9060
Fax Number	:	703-707-9022

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

Provider Enumeration Date	:	03/05/2014
Last Update Date	:	01/26/2023

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Directions to “ CARLENE WALKER PT” Practice Location

Language	Start Address	Practice Location

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