Individual
DR. JACK LINN BELLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
721 RIVER DR, SUITE B, FORT BRAGG, CA 95437
(707) 964-6910
(707) 964-7430
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G47828
CA
Other
Enumeration date
10/05/2006
Last updated
10/10/2012
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