Individual
AMIE WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4411 ALBY ST, ALTON, IL 62002-5916
(618) 474-8052
Mailing address
4411 ALBY ST, ALTON, IL 62002-5916
(618) 474-8052
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70014797
LICENSE #
IL
Enumeration date
08/30/2006
Last updated
11/03/2016
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