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General NPI Number Information
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NPI Number | 1023412087
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Entity Type | Individual
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Provider Name | BRANDON WELLS MS, LAT, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 2601 JESS NEELY DR
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City | NASHVILLE
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State | TN
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Zip | 37212-2039
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Country | US
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Telephone | 615-322-8769
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 JESS NEELY DR
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City | NASHVILLE
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State | TN
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Zip | 37212-2039
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Country | US
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Telephone | 435-227-6081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2364
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License Number State | TN
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