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Individual

DIANNA WELTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
125 E. ADAMS ST., CLAY CITY, IL 62824
(618) 676-1532
(618) 676-1404
Mailing address
P.O. BOX 270345, WEST ALLIS, WI 53227-0345
(414) 529-4180
(414) 858-9082

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-332004
BCBS
IL
01
P00267817
RAILROAD MEDICARE
IL
Enumeration date
08/29/2006
Last updated
07/08/2007
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