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General NPI Number Information
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NPI Number | 1699833665
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Entity Type | Individual
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Provider Name | JOANNE WELLES DPT
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 18 MOHAWK AVE SPARTA TOWNSHIP BOARD OF EDUCATION
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City | SPARTA
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State | NJ
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Zip | 07871-1809
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Country | US
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Telephone | 973-729-2155
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Fax |
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Provider Business Mailing Address
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Address Line | 22 FOREST DR
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City | NEWTON
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State | NJ
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Zip | 07860-6845
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 40QA00271100
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License Number State | NJ
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