Basic Information
| Provider Information | |||||||||
| NPI: | 1902018864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2811 DR JOHN HAYNES DR | ||||||||
| Address2: | STE. 104 | ||||||||
| City: | PELL CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351251447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058847202 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2811 DR JOHN HAYNES DR | ||||||||
| Address2: | STE. 104 | ||||||||
| City: | PELL CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351251447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058847202 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225100000X | PTH 2155 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 510-04741 | 01 | AL | CFI BCBS | OTHER | 515-34453 | 01 | AL | MCE BCBS | OTHER | 515-38642 | 01 | AL | MCB BCBS | OTHER | 510-93979 | 01 | AL | SCR BCBS | OTHER |