Provider Demographics
NPI:1770614828
Name:BELL, JESSICA KAROL (PTA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KAROL
Last Name:BELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 OUACHITA 67
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-8813
Mailing Address - Country:US
Mailing Address - Phone:870-231-4027
Mailing Address - Fax:
Practice Address - Street 1:1320 MAUL RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-2618
Practice Address - Country:US
Practice Address - Phone:870-836-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2038225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant