Provider Demographics
NPI:1437766680
Name:BELL, ERIC EDWARD (CMT/LMT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EDWARD
Last Name:BELL
Suffix:
Gender:M
Credentials:CMT/LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 W 20TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-6246
Mailing Address - Country:US
Mailing Address - Phone:720-404-7786
Mailing Address - Fax:
Practice Address - Street 1:1212 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3610
Practice Address - Country:US
Practice Address - Phone:720-404-7786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0005197225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist