Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 006828 | KY |
N | 2251S0007X | Physical Therapist - Sports | 006828 | KY |
N | 2251X0800X | Physical Therapist - Orthopedic | 006828 | KY |
NPI | 1225707292 |
---|---|
Provider Name | Branden Bell |
First Address | Louisville, KY 40218-3072 |
Second Address | Louisville, KY 40218-3072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2021 |
Last Update Date | 12/09/2021 |