Individual
KENNETH WELKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6915 FOXCROFT DR, SAINT LOUIS, MO 63123-1637
(314) 443-9894
Mailing address
6915 FOXCROFT DR, SAINT LOUIS, MO 63123-1637
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2010031415
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010031415
STATE OF MISSOURI, MISSOURI BOARD OF HEALING ARTS
MO
Enumeration date
02/07/2012
Last updated
02/07/2012
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