Individual
COLLIN RAY WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6475 BRACE ST, DETROIT, MI 48228-4732
(313) 781-5350
Mailing address
6475 BRACE ST, DETROIT, MI 48228-4732
(313) 781-5350
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1701048852
MI
Other
Enumeration date
01/14/2025
Last updated
06/18/2025
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