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General NPI Number Information
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NPI Number | 1336096502
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Entity Type | Individual
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Provider Name | BRAYDON WELCH DPT
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Gender | Male
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 43740 GARFIELD RD
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City | CLINTON TWP
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State | MI
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Zip | 48038-1122
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Country | US
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Telephone | 586-228-0270
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Fax | 586-228-9019
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Provider Business Mailing Address
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Address Line | 22825 ROSEDALE ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-3864
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Country | US
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Telephone | 989-460-7843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501304332
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License Number State | MI
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