Individual
LISA KATHRYN WELLS
Active
Individual
LISA KATHRYN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009
PHYSICAL THERAPY LISCENSE
NM
01
—
318597
SCHOOL PERSONNEL LISCENSE
NM
Enumeration date
04/26/2007
Last updated
07/08/2007
Update your record
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