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Individual

MANDON P WELCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2753 NW LOLO DR, BEND, OR 97703-7288
(541) 728-3412
Mailing address
21090 VIA SANDIA, BEND, OR 97702-9588
(541) 728-3412
(541) 728-3412

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5361
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274467
OR
Enumeration date
04/04/2007
Last updated
07/21/2022
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