Individual
SHAWNA R WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1090 MED PARK DR., LAS CRUCES, NM 88005-3236
(575) 523-7243
(575) 525-5641
Mailing address
25 ARROYO RIDGE RD, ALAMOGORDO, NM 88310-9726
(575) 921-3074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1662
NM
225100000X
Physical Therapist
Primary
PT1662
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K8676
—
NM
Enumeration date
10/13/2006
Last updated
03/10/2022
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