Provider Demographics
NPI:1336383488
Name:WELTIN, TINA
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:WELTIN
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 1:5773 ANCHOR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9276
Mailing Address - Country:US
Mailing Address - Phone:419-349-1892
Mailing Address - Fax:
Practice Address - Street 1:5773 ANCHOR HILLS DR
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9276
Practice Address - Country:US
Practice Address - Phone:419-349-1892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.07132225200000X
MNA1269225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant