Individual
MR. WALTER MAGILL BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1519 TAYLOR ST, COLUMBIA, SC 29201-2918
(803) 779-8327
(803) 799-3603
Mailing address
1519 TAYLOR ST, COLUMBIA, SC 29201-2918
(803) 779-8327
(803) 799-3603
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2734
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2734
SC BOARD OF PHYSICAL THERAPY EXAMINERS
—
Enumeration date
02/07/2012
Last updated
02/07/2012
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