Provider Demographics
NPI:1790491215
Name:BELL, JODY LYNN (MAC, BS, BA)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:BELL
Suffix:
Gender:F
Credentials:MAC, BS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 LADY SLIPPER LN
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5449
Mailing Address - Country:US
Mailing Address - Phone:207-522-7791
Mailing Address - Fax:
Practice Address - Street 1:79 LADY SLIPPER LN
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-5449
Practice Address - Country:US
Practice Address - Phone:207-522-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH297171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty