Healthcare Provider Details

I. General information

NPI: 1851519979
Provider Name (Legal Business Name): RICK SCOTT WELLS D.V.M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 S MILL AVE STE 324
TEMPE AZ
85282-4960
US

IV. Provider business mailing address

3400 S MILL AVE STE 324
TEMPE AZ
85282-4960
US

V. Phone/Fax

Practice location:
  • Phone: 480-966-0391
  • Fax: 480-966-7302
Mailing address:
  • Phone: 480-966-0391
  • Fax: 480-966-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number1237
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: