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Individual

BRYAN CODY WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BHS

Contact information

Practice address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30604011
KY
Enumeration date
08/18/2008
Last updated
08/18/2008
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