Provider Demographics
NPI:1679995799
Name:WALKER, ALISON (PT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:NIEDZWIECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1776
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38025-1776
Mailing Address - Country:US
Mailing Address - Phone:716-465-5933
Mailing Address - Fax:
Practice Address - Street 1:1900 PARR AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2009
Practice Address - Country:US
Practice Address - Phone:731-286-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist