Healthcare Provider Details
I. General information
NPI: 1184016727
Provider Name (Legal Business Name): KYLEE BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/18/2015
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 W POPLAR ST
ROGERS AR
72756-4242
US
IV. Provider business mailing address
1000 W POPLAR ST
ROGERS AR
72756-4242
US
V. Phone/Fax
- Phone: 479-631-7678
- Fax: 479-631-8886
- Phone: 479-631-7678
- Fax: 479-631-8886
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT3973 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: