Healthcare Provider Details

I. General information

NPI: 1386091866
Provider Name (Legal Business Name): ANNA WELTY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1866 REISTERSTOWN RD SUITE F
BALTIMORE MD
21208-1335
US

IV. Provider business mailing address

1866 REISTERSTOWN RD SUITE F
BALTIMORE MD
21208-1335
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-5642
  • Fax: 410-484-5541
Mailing address:
  • Phone: 410-484-5642
  • Fax: 410-484-5541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS03882
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: