Individual
ROY WELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
45 CHURCH ST, SWANTON, VT 05488-1434
(802) 868-2454
(802) 868-2461
Mailing address
PO BOX 235, FAIRFAX, VT 05454-0235
(802) 868-2454
(802) 868-2461
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0550030649
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002358
—
VT
01
—
00049928
BCBS
VT
Enumeration date
08/11/2005
Last updated
10/15/2007
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