Doctor Name: | MR. RANDAL B. WALTON |
NPI Number: | 1689950685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MSG000671 |
Business Practice Address: | 663 S Kralltown Rd East Berlin, PA - 173169137 |
Business Phone Number: | 7172920304 |
Business Fax Number: | |
Mailing Address: | 663 S Kralltown Rd, EAST BERLIN |
State: | PA |
Postal Code: | 173169137 |
Phone Number: | 7172920304 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 03/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MSG000671 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |