Individual
MR. MICHAEL WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
1835 CHICAGO AVE, UNIT A, RIVERSIDE, CA 92507-2378
(909) 908-3920
(909) 394-7411
Mailing address
1835 CHICAGO AVE, UNIT A, RIVERSIDE, CA 92507-2378
(909) 908-3920
(909) 394-7411
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED3921
CA
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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