Provider Demographics
NPI:1134485097
Name:WELTER, SHELBY JOANNE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:JOANNE
Last Name:WELTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 HYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2521
Mailing Address - Country:US
Mailing Address - Phone:828-329-1020
Mailing Address - Fax:
Practice Address - Street 1:75 LEROY GEORGE DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-7461
Practice Address - Country:US
Practice Address - Phone:828-452-8594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4692225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant