Provider Demographics
NPI:1245598689
Name:BELANGER, SCOTT MICHAEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:BELANGER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FEDERAL ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3325
Mailing Address - Country:US
Mailing Address - Phone:413-330-8888
Mailing Address - Fax:
Practice Address - Street 1:28 FEDERAL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3325
Practice Address - Country:US
Practice Address - Phone:413-330-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMT-4978-MT225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist