Provider Demographics
NPI:1750921375
Name:WELSCH, TANNER (DPT)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:
Last Name:WELSCH
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 1:900 N. BAYSHORE DR. VINTAGE PARK AT WATERFRONT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212
Mailing Address - Country:US
Mailing Address - Phone:763-496-4184
Mailing Address - Fax:
Practice Address - Street 1:900 N. BAYSHORE DR. VINTAGE PARK AT WATERFRONT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212
Practice Address - Country:US
Practice Address - Phone:316-945-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2024-05-20
Deactivation Date:2024-05-02
Deactivation Code:
Reactivation Date:2024-05-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist