Basic Information
| Provider Information | |||||||||
| NPI: | 1598096786 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | JULIANNE | ||||||||
| MiddleName: | SIGNAIGO | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4515 POPLAR AVE STE 210 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381177506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017286912 | ||||||||
| FaxNumber: | 9017012428 | ||||||||
| Practice Location | |||||||||
| Address1: | 4515 POPLAR AVE STE 210 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381177506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017286912 | ||||||||
| FaxNumber: | 9017012428 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2010 | ||||||||
| LastUpdateDate: | 09/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 7348 | TN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0446631 | 05 | TN | MEDICAID |