| NPI | 1730232075 |
|---|---|
| Other Name | THERON WELLS MD |
| Entity Type | Organization |
| Authorized Contact | THERON CHARLES WELLS Owner Md 951-371-9391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA g69274) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-11 |