Individual
TARA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
203 JAMESTOWN MALL, FLORISSANT, MO 63034-2908
(314) 518-3725
Mailing address
203 JAMESTOWN MALL, FLORISSANT, MO 63034-2908
(314) 518-3725
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
146168
MO
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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