Larry Walker
Technician, Other in Fort Gordon, GA. Individual provider (NPI-1).
NPI number1730516238
StatusActive
Last updated in NPPESSep 30, 2013
Details
- NPI
- 1730516238
- Entity type
- Individual (NPI-1)
- Name
- Larry Walker
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2013
- Last updated
- Sep 30, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
300 W Hospital RdFort Gordon, GA 30905-5741
Phone 706-787-7217
Mailing address
300 W Hospital RdFort Gordon, GA 30905-5741
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