Provider Demographics
NPI:1336677145
Name:WELLING, COLLEEN
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:WELLING
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 1:527 WRIGHTSTOWN SYKESVILLE RD UNIT 15
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08562-1530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:527 WRIGHTSTOWN SYKESVILLE RD UNIT 15
Practice Address - Street 2:
Practice Address - City:WRIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08562-1530
Practice Address - Country:US
Practice Address - Phone:609-316-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00723300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist