Provider Demographics
NPI:1164022968
Name:BELL, GREGORY R JR
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:R
Last Name:BELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W HENRY ST # B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-6721
Mailing Address - Country:US
Mailing Address - Phone:931-561-3948
Mailing Address - Fax:
Practice Address - Street 1:106 W HENRY ST # B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-6721
Practice Address - Country:US
Practice Address - Phone:931-561-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT011236225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist