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Individual

MRS. DIANE THERESA WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RCPA

Contact information

Practice address
100 SARATOGA VILLAGE BLVD STE 34, BALLSTON SPA, NY 12020-3738
(518) 899-2632
(518) 899-6418
Mailing address
3 OLD SARATOGA KNOLLS LN, SCHUYLERVILLE, NY 12871-1870
(518) 695-5535
(518) 899-6418

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005885-1
NY

Other

Enumeration date
03/12/2007
Last updated
07/08/2010
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