Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CP004439 | NC |
NPI | 1154927549 |
---|---|
Provider Name | Benjamin Thomas Welter |
First Address | Fletcher, NC 28732-8241 |
Second Address | Fletcher, NC 28732-8241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2020 |
Last Update Date | 10/12/2020 |