Individual
LAVORIS WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 767-8513
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 767-8513
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
06/09/2016
Last updated
02/24/2017
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