Provider Demographics
NPI:1477630614
Name:BELLO, KATHERINE JOY (MED, ATC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOY
Last Name:BELLO
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:NH
Mailing Address - Zip Code:03770-0112
Mailing Address - Country:US
Mailing Address - Phone:603-236-2282
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:NH
Practice Address - Zip Code:03770-5250
Practice Address - Country:US
Practice Address - Phone:603-469-2141
Practice Address - Fax:603-469-2046
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer