Individual
MR. WALTER K. CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1480 18TH ST, CORBIN, KY 40701-2721
(606) 528-0870
(606) 528-3449
Mailing address
1480 18TH ST, CORBIN, KY 40701-2721
(606) 528-0891
(606) 528-3449
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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