Provider Demographics
NPI:1255031795
Name:WELLY, ABIGAIL CATHERINE (LDO)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CATHERINE
Last Name:WELLY
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 TIFFIN AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9511
Mailing Address - Country:US
Mailing Address - Phone:419-425-2125
Mailing Address - Fax:419-425-3936
Practice Address - Street 1:2500 TIFFIN AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9511
Practice Address - Country:US
Practice Address - Phone:419-425-2125
Practice Address - Fax:419-425-3936
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.014916-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician