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General NPI Number Information
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NPI Number | 1154442853
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Entity Type | Individual
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Provider Name | ANDREA F WELLS LMT
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 136 MILL ST SUITE 120
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City | GAHANNA
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State | OH
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Zip | 43230-3059
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Country | US
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Telephone | 614-472-0992
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Fax | 614-472-0994
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Provider Business Mailing Address
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Address Line | 1599 NEWPORT LOOP N
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City | GROVE CITY
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State | OH
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Zip | 43123-8177
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Country | US
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Telephone | 614-871-7674
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Fax | 614-871-7674
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 11712
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License Number State | OH
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