Individual
DONNA KENYATTIA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
214 BROUGHTON ST, PEARSON, GA 31642-7044
(912) 592-7945
Mailing address
PO BOX 125, PEARSON, GA 31642-0125
(912) 592-7945
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
08/18/2021
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