Provider Demographics
NPI:1447705314
Name:BELL, ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:28 S. POINT DR.
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38756-3024
Mailing Address - Country:US
Mailing Address - Phone:601-874-2172
Mailing Address - Fax:662-536-7416
Practice Address - Street 1:28 S. POINT DR.
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:MS
Practice Address - Zip Code:38756
Practice Address - Country:US
Practice Address - Phone:601-874-2172
Practice Address - Fax:662-536-7416
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT1291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist