Individual
MRS. MADISON BETH WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1111 UNIVERSITY DR, EDWARDSVILLE, IL 62025-5589
(618) 692-2273
Mailing address
76 E ELM ST, ALTON, IL 62002-4426
(618) 781-3236
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
470667
IL
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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