Provider Demographics
NPI:1447882881
Name:WALKER, YVONNE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:YVONNE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:DEMOPOLIS
Mailing Address - State:AL
Mailing Address - Zip Code:36732-3120
Mailing Address - Country:US
Mailing Address - Phone:334-334-4006
Mailing Address - Fax:
Practice Address - Street 1:951 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:DEMOPOLIS
Practice Address - State:AL
Practice Address - Zip Code:36732-4156
Practice Address - Country:US
Practice Address - Phone:334-498-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty