Provider Demographics
NPI:1912344763
Name:WELKER, JON R (JON WELKER)
Entity type:Individual
Prefix:MR
First Name:JON
Middle Name:R
Last Name:WELKER
Suffix:
Gender:M
Credentials:JON WELKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-3103
Mailing Address - Country:US
Mailing Address - Phone:573-826-5600
Mailing Address - Fax:
Practice Address - Street 1:115 N COLLEGE DR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-3103
Practice Address - Country:US
Practice Address - Phone:573-826-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007001235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist