NPI 1467761148

Brad Afton Walker, BSLPTA

Practitioner Physical Therapy Assistant Fairview Heights, IL

Practice location

Address: 13 Executive Dr Suite 18, Fairview Heights, IL 62208-1342
Phone: (618) 624-8105
Fax: (618) 624-8214

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160-002920 (IL)

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Registry record

NPI: 1467761148
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Sep 2010
Record last updated: 29 Sep 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.