Provider Demographics
NPI:1720966336
Name:BELL, AUTUMN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DEERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:OAK ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28465-8312
Mailing Address - Country:US
Mailing Address - Phone:910-209-5230
Mailing Address - Fax:
Practice Address - Street 1:1 DEERWOOD CIR
Practice Address - Street 2:
Practice Address - City:OAK ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28465-8312
Practice Address - Country:US
Practice Address - Phone:910-209-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22527225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist