Individual
CHANNING WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2711 GREENWAY DR, SUITE A, JACKSON, MS 39204-3304
(601) 922-9300
(601) 922-6312
Mailing address
2711 GREENWAY DR, SUITE A, JACKSON, MS 39204-3304
(601) 922-9300
(601) 922-6312
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
916
MS
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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