Provider Demographics
NPI:1538566617
Name:WALKER, JANICE B (LMT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:B
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 BIRCH ST APT A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2935
Mailing Address - Country:US
Mailing Address - Phone:808-224-3377
Mailing Address - Fax:
Practice Address - Street 1:750 KAPAHULU AVE STE D
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-6020
Practice Address - Country:US
Practice Address - Phone:808-224-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-11802172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist