Basic Information
| Provider Information | |||||||||
| NPI: | 1215437488 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | ASPEN | ||||||||
| MiddleName: | LEA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4402 BLUE DEVILS WAY APT 12 | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591063726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072020949 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3155 AVENUE C | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591028109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066568818 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2018 | ||||||||
| LastUpdateDate: | 02/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTP-PTA-LIC-13208 | MT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.