Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT022913 | PA |
Y | 2251X0800X | Physical Therapist - Orthopedic | ||
N | 2251X0800X | Physical Therapist - Orthopedic | 28741 | FL |
NPI | 1083041362 |
---|---|
Provider Name | Holly Laura Wells |
First Address | Plymouth Meeting, PA 19462-1420 |
Second Address | Kennett Square, PA 19348-2496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 03/10/2017 |