Provider Demographics
NPI:1407188162
Name:BELAMOUR, SHEILA (PTA)
Entity Type:Individual
Prefix:MISS
First Name:SHEILA
Middle Name:
Last Name:BELAMOUR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 40
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542
Mailing Address - Country:US
Mailing Address - Phone:812-661-0385
Mailing Address - Fax:
Practice Address - Street 1:900 ANSON STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167
Practice Address - Country:US
Practice Address - Phone:812-883-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003694A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant