Individual
MARY P WALKER
Active
Individual
MARY P WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511931
—
TN
01
—
4207028
BLUE CROSS BLUE SHIELD TENNESSEE
TN
01
—
P00819872
PALMETTO GBA-RAILROAD MEDICARE
TN
Enumeration date
05/20/2008
Last updated
08/25/2010
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