Individual
CHARLES WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 N 49TH ST, PHILADELPHIA, PA 19139-2718
(215) 471-2866
(215) 471-2866
Mailing address
8241 PROVIDENT ST, PHILADELPHIA, PA 19150-1706
(215) 471-2866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN081780L
PA
Other
Enumeration date
12/31/2025
Last updated
12/31/2025
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