Provider Demographics
NPI:1053495796
Name:WALKER, TRUDY LARIMORE (DR OF CHIROPRACTIC)
Entity type:Individual
Prefix:DR
First Name:TRUDY
Middle Name:LARIMORE
Last Name:WALKER
Suffix:
Gender:F
Credentials:DR OF CHIROPRACTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8681
Mailing Address - Street 2:
Mailing Address - City:CATALINA
Mailing Address - State:AZ
Mailing Address - Zip Code:85738-0681
Mailing Address - Country:US
Mailing Address - Phone:520-825-3103
Mailing Address - Fax:520-825-2225
Practice Address - Street 1:3777 E GOLDER RANCH DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9797
Practice Address - Country:US
Practice Address - Phone:520-825-3103
Practice Address - Fax:520-825-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5580360OtherAETNA
AZ1024511OtherAM SPECIALTY NETWORK
AZ860751510OtherUNITED HEALTH CARE
AZ1053495796OtherAZ BLUE SHIELD
AZ623176OtherAM CHIRO NETWORK
AZA20233000OtherBLUE CROSS BLUE SHIELD
AZ1Z5617OtherHEALTH NET
AZ1053495796OtherAZ BLUE SHIELD
AZ860751510OtherUNITED HEALTH CARE