Provider Demographics
NPI:1508995770
Name:BELANGER, SHEILA (DC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:BELANGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 E FREEWAY DR SE STE A
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5927
Mailing Address - Country:US
Mailing Address - Phone:770-760-1394
Mailing Address - Fax:770-760-8414
Practice Address - Street 1:1003 E FREEWAY DR SE STE A
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5927
Practice Address - Country:US
Practice Address - Phone:770-760-1394
Practice Address - Fax:770-760-8414
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA05870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA350051412OtherRAILROAD
GA665672OtherACN GROUP
GAU74074Medicare UPIN
GA35ZCFMRMedicare ID - Type Unspecified