Provider Demographics
NPI:1194214387
Name:BELLMAN, JOELLE N (PTA)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:N
Last Name:BELLMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3818 E WELLS LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:47424-6102
Mailing Address - Country:US
Mailing Address - Phone:812-699-7710
Mailing Address - Fax:
Practice Address - Street 1:4200 WYNTREE DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2581
Practice Address - Country:US
Practice Address - Phone:812-858-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06005302A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant