Provider Demographics
NPI:1851555932
Name:WELLS, VICTOR VERNON (HEARING AID DEALER)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:VERNON
Last Name:WELLS
Suffix:
Gender:M
Credentials:HEARING AID DEALER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1562 SO FAIRLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-3133
Mailing Address - Country:US
Mailing Address - Phone:812-479-7303
Mailing Address - Fax:812-479-7303
Practice Address - Street 1:1562 SO FAIRLAWN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-3133
Practice Address - Country:US
Practice Address - Phone:812-479-7303
Practice Address - Fax:812-479-7303
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17000292A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist