Provider Demographics
NPI:1649469073
Name:BELL, MIKEL (CO)
Entity type:Individual
Prefix:
First Name:MIKEL
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13771 MONO WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-8803
Mailing Address - Country:US
Mailing Address - Phone:209-532-4497
Mailing Address - Fax:
Practice Address - Street 1:13771 MONO WAY STE A
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-8803
Practice Address - Country:US
Practice Address - Phone:209-532-4497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist