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General NPI Number Information
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NPI Number | 1538639323
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Entity Type | Individual
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Provider Name | PATRICIA ANN WELLS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 6120 STADIUM DR STE 100
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City | KALAMAZOO
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State | MI
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Zip | 49009-3022
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Country | US
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Telephone | 269-372-8555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402
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City | CENTREVILLE
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State | MI
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Zip | 49032-0402
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Country | US
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Telephone |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5501017358
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501017358
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License Number State | MI
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