Individual
ANTHONY SHANE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
12340 STATE ROUTE 104, WAVERLY, OH 45690-8968
(740) 703-1283
(740) 941-5163
Mailing address
12340 STATE ROUTE 104, WAVERLY, OH 45690-8968
(740) 703-1283
(740) 941-5163
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1068
OH
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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