Provider Demographics
NPI:1518343995
Name:BELMORE, RYAN WAYNE (PT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:WAYNE
Last Name:BELMORE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1145 ZONOLITE RD NE
Mailing Address - Street 2:STE 6
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2017
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2750 CHAPEL HILL RD
Practice Address - Street 2:STE 200
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1703
Practice Address - Country:US
Practice Address - Phone:678-981-6290
Practice Address - Fax:678-981-6291
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist