Healthcare Provider Details

I. General information

NPI: 1073424461
Provider Name (Legal Business Name): XAVIER GUY WELCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 E MAIN ST
CARTERSVILLE GA
30121-3305
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 770-383-9734
  • Fax:
Mailing address:
  • Phone: 423-238-8995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT01618
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: