Healthcare Provider Details

I. General information

NPI: 1093168536
Provider Name (Legal Business Name): ANTHONY WELLS JR POST REHAB SPEC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2782 THOMAS RD
BATON ROUGE LA
70807
US

IV. Provider business mailing address

2782 THOMAS RD
BATON ROUGE LA
70807-1610
US

V. Phone/Fax

Practice location:
  • Phone: 225-223-7859
  • Fax:
Mailing address:
  • Phone: 225-223-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: