Provider Demographics
NPI:1528340486
Name:WELSMAN, JENNIFER M (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:WELSMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6650 HIGHLAND RD STE 119
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1662
Mailing Address - Country:US
Mailing Address - Phone:248-618-3050
Mailing Address - Fax:
Practice Address - Street 1:6650 HIGHLAND RD STE 119
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1662
Practice Address - Country:US
Practice Address - Phone:248-618-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0335282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic