Provider Demographics
NPI:1679513048
Name:BELL, AMBER S (PT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:S
Last Name:BELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PIKE ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3414
Mailing Address - Country:US
Mailing Address - Phone:207-839-5860
Mailing Address - Fax:207-839-2499
Practice Address - Street 1:94 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1340
Practice Address - Country:US
Practice Address - Phone:207-839-5860
Practice Address - Fax:207-839-2499
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9915Medicare ID - Type Unspecified