Provider Demographics
NPI:1093845927
Name:CARLSON BELL, REBECCA DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DAWN
Last Name:CARLSON BELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S MILL AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2289
Mailing Address - Country:US
Mailing Address - Phone:602-712-9444
Mailing Address - Fax:602-258-7844
Practice Address - Street 1:2121 S MILL AVE STE 212
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2289
Practice Address - Country:US
Practice Address - Phone:602-712-9444
Practice Address - Fax:602-258-7844
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ07196Medicare ID - Type UnspecifiedTRANSMITTER ID FOR CLAIMS