Individual
ROBERT WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1055 N 500 W, STE 112 BLDG C, PROVO, UT 84604
(801) 812-4624
(801) 812-4699
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13121909-1206
UT
363A00000X
Physician Assistant
PA2070
NV
Other
Enumeration date
01/08/2019
Last updated
01/06/2023
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