Individual
AMANDA WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
553 BRUSHY FORK RD, BRIDGEPORT, WV 26330-6993
(304) 457-6720
Mailing address
553 BRUSHY FORK RD, BRIDGEPORT, WV 26330-6993
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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