Basic Information
| Provider Information | |||||||||
| NPI: | 1639310659 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | STEVE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1354 PARKIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW SHARON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502078035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6415693034 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 RAM DR | ||||||||
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| City: | JEFFERSON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 501292728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153864107 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2009 | ||||||||
| LastUpdateDate: | 03/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 001294 | IA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.