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NPI Code Detail

MEDICARE: TEENA WELCH LMT, MTI, CEPROVIDER

MEDICARE:   TEENA  WELCH  LMT, MTI, CEPROVIDER
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
1225700000XMassage TherapistMT027206TX

General Provider Information

NPI Number : 1710483730
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEENA WELCH LMT, MTI, CEPROVIDER
Provider Business Mailing Address
First Line : 3101 MEADOW LN
Second Line :
City : TAYLOR
State : TX
Zip : 76574-5321
Country : US
Telephone Number : 512-560-1187
Fax Number :
Provider Business Practice Location Address
First Line : 1104 S MAYS ST STE 107
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-6700
Country : US
Telephone Number : 512-560-1187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2018
Last Update Date : 03/30/2018

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Directions to “ TEENA WELCH LMT, MTI, CEPROVIDER” Practice Location

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