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Organization
WELLS VISION AND LASER EYE CENTER, LLC
Active
Organization
WELLS VISION AND LASER EYE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN W WELLS OD (PRESIDENT/OWNER)
(850) 424-6677
Entity
Organization
Contact information
Practice address
4012 COMMONS DR W STE 110, DESTIN, FL 32541-8424
(850) 424-6677
(850) 424-7271
Mailing address
4012 COMMONS DR W STE 110, DESTIN, FL 32541-8424
(850) 424-6677
(850) 424-7271
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2263
OK
332H00000X
Eyewear Supplier
2263
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763300A
—
OK
01
—
1315210001
DME SUPPLIER
OK
Enumeration date
01/04/2007
Last updated
05/16/2012
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