Individual
JORDAN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
(971) 275-7979
Mailing address
1107 MAYWOOD DR, EUREKA, MO 63025-2765
(971) 275-7979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023010678
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/04/2022
Last updated
03/30/2023
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