Provider Demographics
NPI:1558618090
Name:BELL, JOSHUA MATHIAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MATHIAS
Last Name:BELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3778 UNION ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4453
Mailing Address - Country:US
Mailing Address - Phone:765-448-1674
Mailing Address - Fax:765-449-0847
Practice Address - Street 1:3778 UNION ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4453
Practice Address - Country:US
Practice Address - Phone:765-448-1674
Practice Address - Fax:765-449-0847
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010118111N00000X
IN08002608A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor