NPI 1235469925

Derek Wallace Walter, PTA

Practitioner Physical Therapy Assistant Syracuse, NY

Practice location

Address: 1603 Court St, Syracuse, NY 13208-1834
Phone: (315) 455-7591

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X

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Registry record

NPI: 1235469925
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Jan 2010
Record last updated: 4 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.