Provider Demographics
NPI:1982885588
Name:WELLS, JOYCE HOLMES (LMT)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:HOLMES
Last Name:WELLS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 QUAIL POINTE DR
Mailing Address - Street 2:151 SAWGRASS CORNERS #117
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3314
Mailing Address - Country:US
Mailing Address - Phone:904-476-9354
Mailing Address - Fax:
Practice Address - Street 1:312 QUAIL POINTE DR
Practice Address - Street 2:151 SAWGRASS CORNERS #117
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-3314
Practice Address - Country:US
Practice Address - Phone:904-476-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2007-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA26740225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist