Mari Lynne Walson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT005752 Issued in GA

Practice address

318 Columbia Dr
Unit 1508
Carrollton, GA 30117-2050

Phone

(770) 310-2591

Fax

(678) 664-0423

NPI assigned

May 6, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1689840035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 UNION ST",
            "address_2": "UNIT 322",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912709",
            "telephone_number": "770-310-2591",
            "fax_number": "678-664-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 COLUMBIA DR",
            "address_2": "UNIT 1508",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172050",
            "telephone_number": "770-310-2591",
            "fax_number": "678-664-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSON",
        "first_name": "MARI",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT005752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett James Wallace
• Laurri Wallace, PT
• Candler Lindsey Walls Jr., RPH
• Hollis Paul Walls, D.M.D.
• Sheila Reece Walls
• Evah Wangungu
• Jaime Lee Ward
• Paulisa Ward, MD
• Tanisha Nichelle Ward
• Catherine Elizabeth Warren, LCSW

• Physical Therapist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.