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Individual

MR. TROY O'NEIL WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.T.

Contact information

Practice address
108 CLINTON PKWY, CLINTON, MS 39056-4730
(601) 926-2018
(601) 924-9746
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-3205

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3649
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08855377
MS
Enumeration date
10/19/2006
Last updated
03/15/2018
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