Healthcare Provider Details

I. General information

NPI: 1811948730
Provider Name (Legal Business Name): DAVID MARK BELL OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 HOSPITAL RD
NEW RICHMOND WI
54017-1449
US

IV. Provider business mailing address

535 HOSPITAL RD
NEW RICHMOND WI
54017-1449
US

V. Phone/Fax

Practice location:
  • Phone: 715-243-7255
  • Fax: 715-243-7222
Mailing address:
  • Phone: 715-243-7255
  • Fax: 715-243-7222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number103303
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2564-026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: