Provider Demographics
NPI:1679572457
Name:WELKER, ROBERT CARL (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CARL
Last Name:WELKER
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 1:109 SAINT OLAF AVE S
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:MN
Mailing Address - Zip Code:56220-1432
Mailing Address - Country:US
Mailing Address - Phone:507-223-5304
Mailing Address - Fax:507-223-5831
Practice Address - Street 1:109 SAINT OLAF AVE S
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:MN
Practice Address - Zip Code:56220-1432
Practice Address - Country:US
Practice Address - Phone:507-223-5304
Practice Address - Fax:507-223-5831
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
22499OtherSIOUX VALLEY HP
MN231293OtherACN
MN63499CAOtherBCBS
22499OtherSIOUX VALLEY HP