Healthcare Provider Details

I. General information

NPI: 1306176136
Provider Name (Legal Business Name): THOMAS J BELL D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22415 US HIGHWAY 27
LAKE WALES FL
33859-6861
US

IV. Provider business mailing address

405 OSIGIAN BLVD
WARNER ROBINS GA
31088-8958
US

V. Phone/Fax

Practice location:
  • Phone: 863-676-5028
  • Fax: 863-676-5052
Mailing address:
  • Phone: 478-953-3535
  • Fax: 478-953-0353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT24976
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT009660
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: