Individual
DAVID RUSSELL WALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5921 34TH ST, LUBBOCK, TX 79407-3207
(806) 771-3280
(806) 771-3276
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1174281
TX
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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