Individual
JACKSON GUY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 S HIGHWAY 169, GRAND RAPIDS, MN 55744-9552
(218) 326-3431
Mailing address
901 HUBER LN, GLENVIEW, IL 60025-4032
(847) 840-9345
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107811
MN
Other
Enumeration date
06/18/2025
Last updated
06/20/2025
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