Provider Demographics
NPI:1497943211
Name:BELLONI, JOSEPH PAUL (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAUL
Last Name:BELLONI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9668
Mailing Address - Country:US
Mailing Address - Phone:330-877-3177
Mailing Address - Fax:330-877-3525
Practice Address - Street 1:843 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9668
Practice Address - Country:US
Practice Address - Phone:300-877-3177
Practice Address - Fax:330-877-3525
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34176418400OtherMEDICAL MUTUAL
OH34176418400OtherMEDICAL MUTUAL