Provider Demographics
NPI:1568974319
Name:BELL, MANDY YVONNE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:YVONNE
Last Name:BELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MS
Other - First Name:MANDY
Other - Middle Name:YVONNE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:193 BAILEY HOLW
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-8270
Mailing Address - Country:US
Mailing Address - Phone:859-353-9661
Mailing Address - Fax:
Practice Address - Street 1:613 23RD ST STE G30
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2881
Practice Address - Country:US
Practice Address - Phone:606-327-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT13312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer