Provider Demographics
NPI:1891827051
Name:WELAGE, MARY MARKS
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARKS
Last Name:WELAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BALDWICK RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4104
Mailing Address - Country:US
Mailing Address - Phone:412-922-8322
Mailing Address - Fax:412-922-8751
Practice Address - Street 1:2510 BALDWICK RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4104
Practice Address - Country:US
Practice Address - Phone:412-922-8322
Practice Address - Fax:412-922-8751
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 013738L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist