Individual
ALIA MELISSA WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
301 J T STITES BLVD, SALLISAW, OK 74955-9302
(918) 775-9159
Mailing address
111378 S 4757 RD, MULDROW, OK 74948-7573
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA889
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1600889
—
OK
Enumeration date
08/10/2005
Last updated
04/17/2008
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