Provider Demographics
NPI:1780216994
Name:WELCH, SIRJO SEPH
Entity Type:Individual
Prefix:
First Name:SIRJO
Middle Name:SEPH
Last Name:WELCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 REYNOLDSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-9334
Mailing Address - Country:US
Mailing Address - Phone:614-625-0535
Mailing Address - Fax:
Practice Address - Street 1:8330 REYNOLDSWOOD DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-9334
Practice Address - Country:US
Practice Address - Phone:614-625-0535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)