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General NPI Number Information
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NPI Number | 1841317955
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Entity Type | Individual
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Provider Name | DOROTHY E. WELLS PT
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 37241 W. 181 ST. S
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City | BRISTOW
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State | OK
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Zip | 74010-1254
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Country | US
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Telephone | 918-231-5194
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Fax | 918-367-9875
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Provider Business Mailing Address
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Address Line | PO BOX 1254
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City | BRISTOW
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State | OK
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Zip | 74010-1254
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Country | US
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Telephone | 918-231-5194
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Fax | 191-836-7987
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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 | 63
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License Number State | OK
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