Individual
CHANTAVIA WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4808 HEADLEY TER, JACKSONVILLE, FL 32205-1001
(904) 351-6041
Mailing address
4808 HEADLEY TER, JACKSONVILLE, FL 32205-1001
(904) 351-6041
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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