Individual
CONNOR WELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
(763) 746-9492
Mailing address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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