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General NPI Number Information
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NPI Number | 1366707960
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Entity Type | Organization
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Legal Business Name | WELLS HEALTH AND WELLNESS
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 129 S FAYETTEVILLE ST
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City | LIBERTY
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State | NC
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Zip | 27298-3200
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Country | US
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Telephone | 336-622-3000
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Fax | 336-622-3010
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Provider Business Mailing Address
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Address Line | 129 S FAYETTEVILLE ST
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City | LIBERTY
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State | NC
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Zip | 27298-3200
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Country | US
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Telephone | 336-622-3000
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Fax | 336-622-3010
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Authorized Official
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Title or Position | OWNER/NP
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Name | CHERYL WELLS
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Credential | FNP
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Telephone | 336-622-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5004191
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License Number State | NC
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