Individual
JENNA WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2171 SENECA RIDGE DR, MYRTLE BEACH, SC 29579-4178
(239) 233-5240
Mailing address
2171 SENECA RIDGE DR, MYRTLE BEACH, SC 29579-4178
(239) 233-5240
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005365
KY
225100000X
Physical Therapist
Primary
8693
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13329
NORTH CAROLINA BOARD OF PHYSICAL THERAPY
NC
Enumeration date
01/19/2009
Last updated
01/28/2026
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