Provider Demographics
NPI:1750357901
Name:WELCH, JOHN J III (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:WELCH
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MUSTANG TRAIL
Mailing Address - Street 2:SUITE 3
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7516
Mailing Address - Country:US
Mailing Address - Phone:757-486-3222
Mailing Address - Fax:757-498-7353
Practice Address - Street 1:240 MUSTANG TRAIL
Practice Address - Street 2:SUITE 3
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7516
Practice Address - Country:US
Practice Address - Phone:757-486-3222
Practice Address - Fax:757-498-7353
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000300632Medicaid
VA000300632Medicaid
000035S68Medicare ID - Type Unspecified