Provider Demographics
NPI:1740765221
Name:WELDER, WILLIAM CALLAN (LAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CALLAN
Last Name:WELDER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 N MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0040
Mailing Address - Country:US
Mailing Address - Phone:828-649-9601
Mailing Address - Fax:828-649-9601
Practice Address - Street 1:7 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-0040
Practice Address - Country:US
Practice Address - Phone:828-649-9601
Practice Address - Fax:828-649-9601
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNCLAC-788171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist