Individual
CONNIE W WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT, LMBT
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
CERTIFICATION
NC
2255A2300X
Athletic Trainer
0580
NC
225700000X
Massage Therapist
724
NC
Other
Enumeration date
07/06/2006
Last updated
09/11/2025
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