Healthcare Provider Details

I. General information

NPI: 1730809898
Provider Name (Legal Business Name): IRINA L BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 DIAMOND DR
NORTH DINWIDDIE VA
23803-7495
US

IV. Provider business mailing address

621 GREENCASTLE RD
NORTH CHESTERFIELD VA
23236-2603
US

V. Phone/Fax

Practice location:
  • Phone: 804-518-0780
  • Fax:
Mailing address:
  • Phone: 804-912-3454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306604986
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: