Individual
MR. WALTER K. CLEARY
Active
Individual
MR. WALTER K. CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1263
NC
225100000X
Physical Therapist
Primary
966
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000004875
ANTHEM
KY
01
—
640224
UNITED HEALTHCARE
KY
Enumeration date
06/08/2005
Last updated
01/29/2008
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