Individual
MR. GARY ALLEN WELLS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4881 SUGAR MAPLE DR, 88MDG/SGCJ, WRIGHT PATTERSON AFB, OH 45433-5546
(937) 257-1236
Mailing address
4481 SUGARMAPLE DR, FAIRBORN, OH 45333
(937) 608-6661
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN254153
OH
Other
Enumeration date
02/07/2006
Last updated
03/20/2015
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