Provider Demographics
NPI:1356676092
Name:WELSH, CAROL J (PT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:WELSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:J
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9190 PRIORITY WAY WEST DR STE 110
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1437
Mailing Address - Country:US
Mailing Address - Phone:317-805-4963
Mailing Address - Fax:317-818-0720
Practice Address - Street 1:9190 PRIORITY WAY WEST DR STE 110
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1437
Practice Address - Country:US
Practice Address - Phone:317-805-4963
Practice Address - Fax:317-818-0720
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009434A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist