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Individual

MR. JIMMY DALE WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1266 MUCKLE BRANCH RD, ETHRIDGE, TN 38456-7011
(931) 424-3374
Mailing address
1266 MUCKLE BRANCH RD, ETHRIDGE, TN 38456-7011
(931) 424-3374

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000001911
TN

Other

Enumeration date
11/20/2006
Last updated
07/08/2007
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