Individual
MR. BLAKE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
803 OAK STREET, GREEN COVE SPRINGS, FL 32043
(904) 284-5568
Mailing address
11503 SUMMER HAVEN BLVD NORTH, JACKSONVILLE, FL 32258
(702) 237-9835
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA26587
FL
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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