Charles Andrew Walker, LAT, ATC
Individual provider Active NPI Athletic Trainer · O'Fallon, MO
NPI 1649321936 · NPPES record last updated Nov 26, 2013
Key facts
- NPI
- 1649321936
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 865 (MO)
- Practice address
- 604 Winter Meadows Dr.
O'Fallon, MO 63366 - Phone
- (314) 252-2169
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 865 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 865 | MO | Yes |
Addresses
Primary practice location
604 Winter Meadows Dr.
O'Fallon, MO 63366
Mailing address
604 Winter Meadows Dr.
O'Fallon, MO 63366
Phone (314) 252-2169
Other providers in O'Fallon, MO
- Dipali D Thakker
- Total Access Urgent Care, PC
- Maryann L Udy
- Shirley Joyce Vandiver
- Vital Chiropractic LLC
- Washeck Manual Therapy LLC
- Lori Ann Watt
- Aaron Welk
- Wellvana LLC
- James Wendell
All providers in O'Fallon, MO · Athletic Trainer in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.