Individual
KRISTINA WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1373 DADRIAN PROFESSIONAL PARK, GODFREY, IL 62035-1767
(618) 467-7062
Mailing address
9147 HUETTE RD, DORSEY, IL 62021-1131
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006870
IL
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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