Individual
KENNETH LEWIS WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1500 OGLETHORPE AVE, SUITE 500B, ATHENS, GA 30606-2179
(706) 549-9924
(706) 549-6102
Mailing address
1300 DOVE CREEK CIR, WINDER, GA 30680-5039
(770) 725-9904
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000377
GA
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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