Individual
TIM A WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
72589 S 316 RD, WAGONER, OK 74467-7318
(918) 519-8490
Mailing address
72589 S 316 RD, WAGONER, OK 74467-7318
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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