Healthcare Provider Details

I. General information

NPI: 1528344082
Provider Name (Legal Business Name): DEBRA K WELSH ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E CHERRY ST
MC CONNELLSBURG PA
17233-1400
US

IV. Provider business mailing address

218 S 7TH ST
MC CONNELLSBURG PA
17233-1504
US

V. Phone/Fax

Practice location:
  • Phone: 717-485-4438
  • Fax:
Mailing address:
  • Phone: 717-485-4438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT002153A
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: