Individual
MR. THOMAS TARRY WELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
221 W. MARYDALE AVE, SOLDOTNA, AK 99669
(907) 262-2596
Mailing address
221 W MARYDALE AVE, SOLDOTNA, AK 99669-7420
(907) 262-2596
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0695
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0695
—
AK
Enumeration date
03/06/2007
Last updated
02/29/2008
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