Provider Demographics
NPI:1306396122
Name:WELLS, LINDSEY (ND)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 BUCKLAND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3737
Mailing Address - Country:US
Mailing Address - Phone:860-432-9923
Mailing Address - Fax:860-432-7553
Practice Address - Street 1:469 BUCKLAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-3737
Practice Address - Country:US
Practice Address - Phone:860-432-9923
Practice Address - Fax:860-432-7553
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT572175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath