| Doctor Name: | BRIAN WELLS |
| NPI Number: | 1780995399 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 1092363 |
| Business Practice Address: | 7321 Balmer St Hill Afb, UT - 840565012 |
| Business Phone Number: | 8017775825 |
| Business Fax Number: | |
| Mailing Address: | 1425 Kays Creek Dr, LAYTON |
| State: | UT |
| Postal Code: | 840408256 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2010 |
| NPI Last Update Date: | 06/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1092363 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |