Provider Demographics
NPI:1538167150
Name:WALKER CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:WALKER CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-293-8882
Mailing Address - Street 1:250 25TH ST S
Mailing Address - Street 2:SUITE B
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6817
Mailing Address - Country:US
Mailing Address - Phone:701-293-8882
Mailing Address - Fax:701-293-8854
Practice Address - Street 1:250 25TH ST S
Practice Address - Street 2:SUITE B
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6817
Practice Address - Country:US
Practice Address - Phone:701-293-8882
Practice Address - Fax:701-293-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13213Medicaid
ND13213Medicaid
U84961Medicare UPIN