Provider Demographics
NPI:1376661538
Name:WELCH, LINDSEY (MSPT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MARTER AVE
Mailing Address - Street 2:BUILDING 500, SUITE 504
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3124
Mailing Address - Country:US
Mailing Address - Phone:856-914-1400
Mailing Address - Fax:856-914-1444
Practice Address - Street 1:110 MARTER AVE
Practice Address - Street 2:BUILDING 500, SUITE 504
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-914-1400
Practice Address - Fax:856-914-1444
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
40QA01230000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist