Provider Demographics
NPI:1093866204
Name:WELCH, LORIN M (DC)
Entity Type:Individual
Prefix:DR
First Name:LORIN
Middle Name:M
Last Name:WELCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12152 N RANCHO VISTOSO BLVD
Mailing Address - Street 2:#110
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1843
Mailing Address - Country:US
Mailing Address - Phone:520-877-9100
Mailing Address - Fax:520-877-9280
Practice Address - Street 1:12152 N RANCHO VISTOSO BLVD
Practice Address - Street 2:#110
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1843
Practice Address - Country:US
Practice Address - Phone:520-877-9100
Practice Address - Fax:520-877-9280
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ69528Medicare ID - Type Unspecified