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NPI Code Detail

MEDICARE: TARA YG WELTY L.AC.

MEDICARE: TARA YG WELTY L.AC.
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
1171100000XAcupuncturist96220WV
2171100000XAcupuncturist000315OH

General Provider Information

NPI Number : 1336563121
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA YG WELTY L.AC.
Provider Business Mailing Address
First Line : 1208 37TH ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-1149
Country : US
Telephone Number : 304-699-1765
Fax Number :
Provider Business Practice Location Address
First Line : 911 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-2526
Country : US
Telephone Number : 304-699-1765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2014
Last Update Date : 07/08/2016

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Directions to “ TARA YG WELTY L.AC.” Practice Location

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