Individual
MR. IAN ANTHONY WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1693
(636) 949-4346
Mailing address
4004 SUN LAKE DR, SAINT CHARLES, MO 63301-3059
(703) 209-3967
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2019032064
MO
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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