Provider Demographics
NPI:1740551001
Name:BELL, ROGER HUGHES (DC)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:HUGHES
Last Name:BELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 NW UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2285
Mailing Address - Country:US
Mailing Address - Phone:631-978-1156
Mailing Address - Fax:
Practice Address - Street 1:550 NW UNIVERSITY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2285
Practice Address - Country:US
Practice Address - Phone:631-978-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor