Provider Demographics
NPI:1437011673
Name:WALKER, RILEY L
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:L
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HOPKINS LN
Mailing Address - Street 2:
Mailing Address - City:EOLIA
Mailing Address - State:MO
Mailing Address - Zip Code:63344-1041
Mailing Address - Country:US
Mailing Address - Phone:636-775-5983
Mailing Address - Fax:
Practice Address - Street 1:411 CENTRAL METHODIST SQ STE 1
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1198
Practice Address - Country:US
Practice Address - Phone:877-268-1854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer