Provider Demographics
NPI:1063408961
Name:WALSH, DAVID ALLEN (RPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:WALSH
Suffix:
Gender:M
Credentials:RPT
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Mailing Address - Street 1:349 SOUTH DONAHUE DRIVE
Mailing Address - Street 2:PLAINSMAN PARK PHYSICAL THERAPY
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36849-0001
Mailing Address - Country:US
Mailing Address - Phone:334-844-9919
Mailing Address - Fax:334-844-8139
Practice Address - Street 1:349 SOUTH DONAHUE DRIVE
Practice Address - Street 2:PLAINSMAN PARK PHYSICAL THERAPY
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-9919
Practice Address - Fax:334-844-8139
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPTH30662251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH3066OtherPHYSCIAL THERAPIST LICENS