Provider Demographics
NPI:1104227578
Name:WALKER, BRANDON JAMES (DPT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMES
Last Name:WALKER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2742
Mailing Address - Country:US
Mailing Address - Phone:620-474-2950
Mailing Address - Fax:
Practice Address - Street 1:608 E HAROLD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-2742
Practice Address - Country:US
Practice Address - Phone:620-474-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist