Individual
DESIREE F WELTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1059 PINEWOOD CIR, TWIN FALLS, ID 83301-3338
(208) 733-1775
(208) 733-1775
Mailing address
1059 PINEWOOD CIR, TWIN FALLS, ID 83301-3338
(208) 733-1775
(208) 733-1775
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
50298
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807928300
—
ID
Enumeration date
05/22/2008
Last updated
05/22/2008
About Stedi
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