Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1936 | LA |
N | 111NP0017X | Pediatric Chiropractor | 1936 | LA |
NPI | 1124784509 |
---|---|
Provider Name | Dr. Heather Welling |
First Address | Lake Charles, LA 70601-7976 |
Second Address | Lake Charles, LA 70601-7976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2021 |
Last Update Date | 10/11/2021 |