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1740024983
ETHAN CHARLES WELLS
CLEMMONS, NC
NPI
1740024983
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 1219652)
Enumeration Date
2024-06-22
Last Update Date
2024-10-17
Business Address
Mr. ETHAN CHARLES WELLS PA-C
7210 VILLAGE MEDICAL CIR STE 110
CLEMMONS, NC 27012-8041
Phone number: 336-893-2400
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Mailing Address
Mr. ETHAN CHARLES WELLS PA-C
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone number: 336-893-2400
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