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Individual

MR. WADE M WELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
411 CENTRAL METHODIST SQ, CENTRAL METHODIST UNIVERSITY, FAYETTE, MO 65248-1104
(660) 248-6217
(660) 248-6381
Mailing address
521 COUNTY ROAD 105, FAYETTE, MO 65248-8833
(660) 248-6217
(660) 248-6381

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
102437
MO

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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