Individual
CYDNEI OCTAVIA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
123 N COLLEGE ST, ITASCA, TX 76055-2307
(254) 687-2922
Mailing address
330 OLD BRANDON RD, MILFORD, TX 76670-1182
(903) 922-1362
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT9010
TX
Other
Enumeration date
07/26/2021
Last updated
06/27/2023
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