Healthcare Provider Details
I. General information
NPI: 1689796013
Provider Name (Legal Business Name): ZACHARY J. WELLS D.C. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2007
Last Update Date: 11/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3170 W CAREFREE HWY SUITE 5
PHOENIX AZ
85086-3205
US
IV. Provider business mailing address
150 E SHARON AVE
PHOENIX AZ
85022-4731
US
V. Phone/Fax
- Phone: 623-587-9036
- Fax: 623-587-9250
- Phone: 623-217-3586
- Fax: 866-821-3750
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 7137 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
ZACHARY
J.
WELLS
Title or Position: OWNER
Credential: D.C.
Phone: 623-217-3586