Healthcare Provider Details

I. General information

NPI: 1750155065
Provider Name (Legal Business Name): AIRIKKA WELCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 SPRING CANYON HTS APT 208
COLORADO SPRINGS CO
80907-3480
US

IV. Provider business mailing address

4525 SPRING CANYON HTS APT 208
COLORADO SPRINGS CO
80907-3480
US

V. Phone/Fax

Practice location:
  • Phone: 719-493-3251
  • Fax:
Mailing address:
  • Phone: 719-493-3251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0017269
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: