1699947309 NPI number — WALKER PHYSICAL THERAPY, INC.

Table of content: MISS MEGHAN ELIZABETH GALLAGHER NP (NPI 1619278280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699947309 NPI number — WALKER PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALKER PHYSICAL THERAPY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699947309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1644 E 900 S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGVILLE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84663-9539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-787-0484
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 EAST 400 SOUTH
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
SPRINGVILLE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-787-0484
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
801-787-0484

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  114536-2401 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 528941664046 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".




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