Provider Demographics
NPI:1811014855
Name:WELSH, WIILIAM EDWARD (ATC)
Entity Type:Individual
Prefix:
First Name:WIILIAM
Middle Name:EDWARD
Last Name:WELSH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 WOODLAKE RD
Mailing Address - Street 2:
Mailing Address - City:STAMPING GROUND
Mailing Address - State:KY
Mailing Address - Zip Code:40379-9783
Mailing Address - Country:US
Mailing Address - Phone:859-351-9577
Mailing Address - Fax:
Practice Address - Street 1:1726 WOODLAKE RD
Practice Address - Street 2:
Practice Address - City:STAMPING GROUND
Practice Address - State:KY
Practice Address - Zip Code:40379-9783
Practice Address - Country:US
Practice Address - Phone:859-351-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT 2832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer