MEDICARE: DR. CASEY H WALKER D.C.

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	111N00000X	Chiropractor	59561091202	UT
2	111N00000X	Chiropractor	08002528A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IN1267001	OTHER	IN	MEDICARE

General Provider Information

NPI Number	:	1770537045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASEY H WALKER D.C.

Provider Business Mailing Address
First Line	:	767 COACH LIGHT LN
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356-7905
Country	:	US
Telephone Number	:	801-494-9769
Fax Number	:

Provider Business Practice Location Address
First Line	:	2072 E COMMERCIAL AVE STE B
Second Line	:
City	:	LOWELL
State	:	IN
Zip	:	46356
Country	:	US
Telephone Number	:	219-696-8916
Fax Number	:	219-696-6880

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	11/03/2021

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Directions to “ DR. CASEY H WALKER D.C.” Practice Location

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