Jack M Wells, LMT

NPI #1023220860 in Keizer, Oregon

Provider Information

NPI Number: 1023220860
Entity Type: Individual
Name: Jack M Wells, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: May 4, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4630 RIVER RD N
City: Keizer
State: Oregon
ZIP Code: 97303-4648
Phone: (503) 999-8062

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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