Jimmy Dale Walker
Individual provider Active NPI Physical Therapy Assistant · Ethridge, TN
NPI 1831263607 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831263607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA0000001911 (TN)
- Practice address
- 1266 Muckle Branch Rd
Ethridge, TN 38456-7011 - Phone
- (931) 424-3374
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| PTA0000001911 | TN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA0000001911 | TN | Yes |
Addresses
Primary practice location
1266 Muckle Branch Rd
Ethridge, TN 38456-7011
Mailing address
1266 Muckle Branch Rd
Ethridge, TN 38456-7011
Phone (931) 424-3374
Other providers in Ethridge, TN
- Aaron R McKey
- Niswander Family Medicine Inc
- Autumn Danielle Scott
- Dustin Staggs
- Tennessee Orthopaedic Alliance PA
- Whole Woman Birth and Wellness
- Joseph Yocom
All providers in Ethridge, TN · Physical Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.