Provider Demographics
NPI:1093060121
Name:BELL, WAYNE A (EMT-I)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:A
Last Name:BELL
Suffix:
Gender:M
Credentials:EMT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:724 FRONT ST
Mailing Address - Street 2:SUITE 523
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-3589
Mailing Address - Country:US
Mailing Address - Phone:307-789-2205
Mailing Address - Fax:307-789-2593
Practice Address - Street 1:724 FRONT ST
Practice Address - Street 2:SUITE 523
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-3589
Practice Address - Country:US
Practice Address - Phone:307-789-2205
Practice Address - Fax:307-789-2593
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory