Individual
MR. MARK LEE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3224 S BROADWAY STE 112, EDMOND, OK 73013-4069
(405) 427-4945
Mailing address
1605 REDBUD HOLW, EDMOND, OK 73034-9719
(405) 206-5824
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1099
OK
Other
Enumeration date
02/03/2006
Last updated
02/17/2024
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