Healthcare Provider Details

I. General information

NPI: 1740329002
Provider Name (Legal Business Name): WILLIAM A WELLS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 HWY 116
FORESTVILLE CA
95436-9397
US

IV. Provider business mailing address

6130 HWY 116
FORESTVILLE CA
95436-9397
US

V. Phone/Fax

Practice location:
  • Phone: 707-887-1206
  • Fax: 707-887-7727
Mailing address:
  • Phone: 707-887-1206
  • Fax: 707-887-7727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 10970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: