Provider Demographics
NPI:1497303994
Name:WELCH, EMILY (DC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 W VOTAW ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-1344
Mailing Address - Country:US
Mailing Address - Phone:260-726-3065
Mailing Address - Fax:260-726-3406
Practice Address - Street 1:406 W VOTAW ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-1344
Practice Address - Country:US
Practice Address - Phone:260-726-3065
Practice Address - Fax:260-726-3406
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003086A111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic