Provider Demographics
NPI:1194837559
Name:WELCH, DANIEL E (ATC/L)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:E
Last Name:WELCH
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 SPRING HOUSE LN
Mailing Address - Street 2:APT B
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-1719
Mailing Address - Country:US
Mailing Address - Phone:706-840-1836
Mailing Address - Fax:
Practice Address - Street 1:3624 J DEWEY GRAY CIR
Practice Address - Street 2:SUITE 302
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6584
Practice Address - Country:US
Practice Address - Phone:706-651-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0011992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer