Provider Demographics
NPI:1760522700
Name:BELL, BRYAN W (,CHIROPRACTOR, PA)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:W
Last Name:BELL
Suffix:
Gender:M
Credentials:,CHIROPRACTOR, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 US HIGHWAY 1 S
Mailing Address - Street 2:SUITE B
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6352
Mailing Address - Country:US
Mailing Address - Phone:904-797-3232
Mailing Address - Fax:904-797-3234
Practice Address - Street 1:2820 US HIGHWAY 1 S
Practice Address - Street 2:SUITE B
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6352
Practice Address - Country:US
Practice Address - Phone:904-797-3232
Practice Address - Fax:904-797-3234
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003959111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician