Individual
BROCK KENYON WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
600 N ROBBINS RD STE 101, BOISE, ID 83702-4567
(208) 385-3069
Mailing address
3467 N ELMSTONE AVE, MERIDIAN, ID 83646-4911
(435) 773-2181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5768
ID
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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