Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | PT00704 | RI |
NPI | 1255542445 |
---|---|
Provider Name | Debra Lynne Belcher |
First Address | North Kingstown, RI 02852-1527 |
Second Address | Providence, RI 02912-9090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2007 |
Last Update Date | 08/07/2007 |