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General NPI Number Information
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NPI Number | 1710483730
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Entity Type | Individual
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Provider Name | TEENA WELCH LMT, MTI, CEPROVIDER
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Gender | Female
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 1104 S MAYS ST STE 107
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City | ROUND ROCK
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State | TX
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Zip | 78664-6700
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Country | US
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Telephone | 512-560-1187
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 MEADOW LN
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City | TAYLOR
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State | TX
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Zip | 76574-5321
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Country | US
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Telephone | 512-560-1187
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT027206
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License Number State | TX
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