Healthcare Provider Details

I. General information

NPI: 1740445527
Provider Name (Legal Business Name): WELSH CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 4TH ST S
NORTHWOOD IA
50459-1908
US

IV. Provider business mailing address

104 4TH ST S
NORTHWOOD IA
50459-1908
US

V. Phone/Fax

Practice location:
  • Phone: 641-324-1626
  • Fax: 641-324-1626
Mailing address:
  • Phone: 641-324-1626
  • Fax: 641-324-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5065
License Number StateIA

VIII. Authorized Official

Name: DR. JAMES WILLIAM WELSH
Title or Position: OWNER/CHIROPRACTOR
Credential:
Phone: 641-324-1626