Provider Demographics
NPI:1356409478
Name:CARRIE S. WELCH, D. C. , PLLC
Entity type:Organization
Organization Name:CARRIE S. WELCH, D. C. , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:703-476-8700
Mailing Address - Street 1:12359 SUNRISE VALLEY DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3462
Mailing Address - Country:US
Mailing Address - Phone:703-476-8700
Mailing Address - Fax:703-476-1825
Practice Address - Street 1:12359 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 140
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3462
Practice Address - Country:US
Practice Address - Phone:703-476-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty