Provider Demographics
NPI:1912510769
Name:WELLE, MEGHAN MICHELLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:MICHELLE
Last Name:WELLE
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 1:12218 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:KY
Mailing Address - Zip Code:40026-9446
Mailing Address - Country:US
Mailing Address - Phone:502-851-5800
Mailing Address - Fax:
Practice Address - Street 1:190 SHADOWMEADE LN
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-6277
Practice Address - Country:US
Practice Address - Phone:502-538-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist