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General NPI Number Information
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NPI Number | 1548383227
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Entity Type | Individual
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Provider Name | RONALD BLAZE WELCH D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 326 S EUCLID AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1613
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Country | US
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Telephone | 208-263-7411
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Fax | 208-255-4578
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Provider Business Mailing Address
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Address Line | 206 N 2ND AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1419
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Country | US
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Telephone | 208-263-7411
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Fax | 208-255-4578
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA-599
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License Number State | ID
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