Individual
DR. CHARLA DANIELLE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 223-5636
Mailing address
515 S WASHINGTON ST, APT 1, ARDMORE, OK 73401-7091
(580) 264-0406
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0058148
OK
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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