Provider Demographics
NPI:1477337871
Name:BELL, MEGHAN KATHRYN
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:KATHRYN
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 E COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5158
Practice Address - Country:US
Practice Address - Phone:575-622-6500
Practice Address - Fax:575-622-9777
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP025830T225100000X
NMPT-2024-0079225100000X
NJ40QA02187900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist