Provider Demographics
NPI:1497586085
Name:BELL, BYRON
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-4711
Mailing Address - Country:US
Mailing Address - Phone:307-856-8092
Mailing Address - Fax:307-463-4254
Practice Address - Street 1:450 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-4711
Practice Address - Country:US
Practice Address - Phone:307-856-8092
Practice Address - Fax:307-463-4254
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty