Healthcare Provider Details

I. General information

NPI: 1790726453
Provider Name (Legal Business Name): JAMES HUBERT WELSH JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15420 S HARRELLS FERRY RD STE A
BATON ROUGE LA
70816-2933
US

IV. Provider business mailing address

8080 BLUEBONNET BLVD SUITE 110
BATON ROUGE LA
70810-7827
US

V. Phone/Fax

Practice location:
  • Phone: 225-214-5330
  • Fax: 225-214-5333
Mailing address:
  • Phone: 225-408-7990
  • Fax: 225-408-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number00882
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: