Individual
JACQUELINE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 WHIPOORWILL WAY, DUBLIN, GA 31021-2621
(478) 290-5286
Mailing address
100 WHIPOORWILL WAY, DUBLIN, GA 31021-2621
(478) 290-5286
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
16-00006136
GA
Other
Enumeration date
01/17/2016
Last updated
01/17/2016
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