Provider Demographics
NPI:1639146046
Name:WELLS, BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:WELLS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 US HIGHWAY 431 N
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206-1966
Mailing Address - Country:US
Mailing Address - Phone:256-237-6400
Mailing Address - Fax:256-237-6475
Practice Address - Street 1:1019 US HIGHWAY 431 N
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206-1966
Practice Address - Country:US
Practice Address - Phone:256-237-6400
Practice Address - Fax:256-237-6475
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000073098Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER