Individual
KESHIA D WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1070 VINEHAVEN DR NE, CONCORD, NC 28025-2438
(704) 783-1840
Mailing address
1070 VINEHAVEN DR NE, CONCORD, NC 28025-2438
(704) 783-1840
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-04250
NC
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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