Provider Information for 1174877153
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Ms. IESHA SHONTA BELL
Sex: Female
NPI: 1174877153
Last Updated: 2024-09-20
Certification Date: 2024-09-20
Certification Date: 2024-09-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174877153 | ||||||||
| Enumeration Date | 2012-10-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 107 WATERING ST TABOR CITY, NC 28463-1639 United States Phone: 910-212-0623 | Fax: | ||||||||
| Primary Practice Address | 803 SOUTH MAIN STREET BLADENBORO, NC 28320 United States Phone: 910-863-4000 | Fax: | ||||||||
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