Provider Demographics
NPI:1578186649
Name:BELL, ABBY LEWIS
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:LEWIS
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 1:1714 WOLF CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-2353
Mailing Address - Country:US
Mailing Address - Phone:375-082-5053
Mailing Address - Fax:337-508-2506
Practice Address - Street 1:1714 WOLF CIR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2353
Practice Address - Country:US
Practice Address - Phone:375-082-5053
Practice Address - Fax:337-508-2506
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA105812251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics