MEDICARE: JULIA BELL RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1501X	Sports Dietetics Nutrition Registered Dietitian	86076017

General Provider Information

NPI Number	:	1497396642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA BELL RD

Provider Business Mailing Address
First Line	:	57 TODD PL NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1377
Country	:	US
Telephone Number	:	615-947-6142
Fax Number	:

Provider Business Practice Location Address
First Line	:	7701 TELEGRAPH RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-3822
Country	:	US
Telephone Number	:	615-947-6142
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2019
Last Update Date	:	09/30/2019

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