THERON WELLS MD INCORPORATED
Mental Health at Magnolia Ave, Corona, CA

License number
California G69274
Category
Mental Health
Type
Mental Health
Owner
Name: THERON CHARLES WELLS MD
Title: OWNER-MD
Phone: (951) 371-9391
Address
Address
730 Magnolia Ave, Corona, CA 92879
National Provider ID: 1730232075
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THERON WELLS, M.D., INC., A PROFESSIONAL MEDICAL CORPORATION

1811 Deerfield Cir, Corona, CA 92882

Status:
Inactive
Registration:
Jun 17, 1994
State ID:
C1891139
Business type:
Articles of Incorporation
President:
Theron C. Wells President, inactive
Agent:
Shawna Hennessy,Riverside, CA 92503 (Physical)

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