Provider Demographics
NPI:1528633013
Name:WELCH, ALICE A D (PT, MSPT)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:A D
Last Name:WELCH
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 W HEBRON LN STE 106
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7466
Mailing Address - Country:US
Mailing Address - Phone:502-510-1445
Mailing Address - Fax:
Practice Address - Street 1:1905 W HEBRON LN STE 106
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7466
Practice Address - Country:US
Practice Address - Phone:502-510-1445
Practice Address - Fax:502-957-1257
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist