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Individual

DR. KEVIN W WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4012 COMMONS DR W, STE 110, DESTIN, FL 32541-8422
(580) 223-5300
(580) 223-5356
Mailing address
4012 COMMONS DR W, SUITE 110, DESTIN, FL 32541-8422
(580) 223-5300
(580) 223-5356

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2263
OK
152WC0802X
Corneal and Contact Management Optometrist
2263
OK
152WL0500X
Low Vision Rehabilitation Optometrist
2263
OK
152WP0200X
Pediatric Optometrist
2263
OK
152WS0006X
Sports Vision Optometrist
2263
OK
152WV0400X
Vision Therapy Optometrist
2263
OK
152WX0102X
Occupational Vision Optometrist
2263
OK

Other

Enumeration date
10/25/2006
Last updated
11/21/2011
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