Provider Demographics
NPI:1396481800
Name:WELCH, ZACHARY BRYENT (DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:BRYENT
Last Name:WELCH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69210-1127
Mailing Address - Country:US
Mailing Address - Phone:402-760-2223
Mailing Address - Fax:
Practice Address - Street 1:304 W EVERGREEN AVE STE 101
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6970
Practice Address - Country:US
Practice Address - Phone:907-745-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-08
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic