Individual
KATHRYN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
210 E TORRANCE AVE, PONTIAC, IL 61764-2746
(815) 842-1122
Mailing address
210 E TORRANCE AVE, PONTIAC, IL 61764-2746
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043084397
IL
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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