MEDICARE: TRAVIS WALKE DPT, 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	225100000X	Physical Therapist	2305215506	VA

General Provider Information

NPI Number	:	1750090866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS WALKE DPT, PT

Provider Business Mailing Address
First Line	:	1450 KEMPSVILLE RD STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-7320
Country	:	US
Telephone Number	:	757-962-1618
Fax Number	:	757-481-6175

Provider Business Practice Location Address
First Line	:	637 KINGSBOROUGH SQ
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-4944
Country	:	US
Telephone Number	:	757-547-7554
Fax Number	:

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

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	12/17/2025

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