Provider Demographics
NPI:1598941221
Name:WELSH, JARRET LEE (DC)
Entity Type:Individual
Prefix:
First Name:JARRET
Middle Name:LEE
Last Name:WELSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8885 RIO SAN DIEGO DR
Mailing Address - Street 2:SUITE 347
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1624
Mailing Address - Country:US
Mailing Address - Phone:619-293-3453
Mailing Address - Fax:619-216-1444
Practice Address - Street 1:8885 RIO SAN DIEGO DR
Practice Address - Street 2:SUITE 347
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1624
Practice Address - Country:US
Practice Address - Phone:619-293-3453
Practice Address - Fax:619-216-1444
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30724111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NR0400XChiropractic ProvidersChiropractorRehabilitation