Individual
BROOKE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
78 HOSPITAL RD, MACON, MS 39341-2490
(662) 726-4231
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-3509
MS
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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