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NPI Code Detail

MEDICARE: MS. KYLIE ERIN WELCH OTR

MEDICARE: MS. KYLIE ERIN WELCH OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1295088219
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KYLIE ERIN WELCH OTR
Provider Business Mailing Address
First Line : 5500 COPPER CRK
Second Line :
City : FLOYDS KNOBS
State : IN
Zip : 47119-9259
Country : US
Telephone Number : 502-552-2393
Fax Number :
Provider Business Practice Location Address
First Line : 4538 N BEACON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-5519
Country : US
Telephone Number : 773-275-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2012
Last Update Date : 10/16/2012

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