Provider Demographics
NPI:1548525017
Name:WELCH, LEE M (PT, DPT)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:M
Last Name:WELCH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E WILLIAMS ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-7764
Mailing Address - Country:US
Mailing Address - Phone:919-372-8412
Mailing Address - Fax:919-267-6556
Practice Address - Street 1:2121 E WILLIAMS ST
Practice Address - Street 2:SUITE 108
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-7764
Practice Address - Country:US
Practice Address - Phone:919-372-8412
Practice Address - Fax:919-267-6556
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1548525017OtherMEDICAID QMB
VAC05954OtherGROUP MEDICARE PTAN
VI1548525017OtherMEDICAID QMB