Provider Demographics
NPI:1336815430
Name:WELTY, ABBY RUTH (OTA)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:RUTH
Last Name:WELTY
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8314 N 1912 RD
Mailing Address - Street 2:
Mailing Address - City:LEEDEY
Mailing Address - State:OK
Mailing Address - Zip Code:73654-6035
Mailing Address - Country:US
Mailing Address - Phone:580-821-4485
Mailing Address - Fax:
Practice Address - Street 1:101 N POST RD STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-3605
Practice Address - Country:US
Practice Address - Phone:405-397-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant