Individual
LAVAUGHN WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 LAFAYETTE AVE, COUNCIL BLUFFS, IA 51503-3025
(402) 813-9400
Mailing address
255 LAFAYETTE AVE, COUNCIL BLUFFS, IA 51503-3025
(402) 813-9400
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180AN4583
DRIVER'S LICENSE
IA
Enumeration date
12/15/2022
Last updated
12/15/2022
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