Provider Demographics
NPI:1700107679
Name:WELKER, JESSICA L (DPT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:WELKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 CORDOVA RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0520
Mailing Address - Country:US
Mailing Address - Phone:901-756-1650
Mailing Address - Fax:901-756-1396
Practice Address - Street 1:8110 CORDOVA RD
Practice Address - Street 2:SUITE 107
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0520
Practice Address - Country:US
Practice Address - Phone:901-756-1650
Practice Address - Fax:901-756-1396
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist