Provider Demographics
NPI:1538328356
Name:WELCH, AMY (PT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901
Mailing Address - Country:US
Mailing Address - Phone:719-776-8140
Mailing Address - Fax:719-776-8150
Practice Address - Street 1:550 HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132
Practice Address - Country:US
Practice Address - Phone:719-481-0161
Practice Address - Fax:719-481-1397
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORPT 5901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist