Provider Demographics
NPI:1902976145
Name:BELL, LARRY D (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:D
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 1:103 ANNJO COURT
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551
Mailing Address - Country:US
Mailing Address - Phone:434-455-2484
Mailing Address - Fax:434-455-2486
Practice Address - Street 1:103 ANNJO COURT
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551
Practice Address - Country:US
Practice Address - Phone:434-455-2484
Practice Address - Fax:434-455-2486
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV02495Medicare UPIN
PA085880THGMedicare ID - Type Unspecified