Provider Demographics
NPI:1033585062
Name:BELL, BETHANY L (DPT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:L
Last Name:BELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:L
Other - Last Name:HYDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:
Practice Address - Street 1:8005 W FLORISSANT AVE
Practice Address - Street 2:STE L
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-1452
Practice Address - Country:US
Practice Address - Phone:314-833-1000
Practice Address - Fax:314-833-1001
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027115225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist