Individual
PHYLLIS D WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1621 HIGHWAY 17 N, NORTH MYRTLE BEACH, SC 29582-2229
(843) 353-3460
(843) 353-3461
Mailing address
137 FRONT ST, DEPOSIT, NY 13754-1128
(607) 467-5858
(607) 467-5655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0075661
NY
225100000X
Physical Therapist
Primary
11392
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11226693
CAQH
NY
01
—
P00471498
RAIL ROAD MEDICARE
NY
Enumeration date
03/06/2007
Last updated
08/15/2022
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