Provider Demographics
NPI:1497207518
Name:BELL, LAWRENCE A (SCOTT)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:A
Last Name:BELL
Suffix:
Gender:M
Credentials:SCOTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52802-3517
Mailing Address - Country:US
Mailing Address - Phone:563-528-3507
Mailing Address - Fax:563-326-7840
Practice Address - Street 1:824 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52802-3517
Practice Address - Country:US
Practice Address - Phone:563-528-3507
Practice Address - Fax:563-326-7840
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA839ZZO748344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi