Provider Demographics
NPI:1538687892
Name:BELLOIR, BRANDON L (DPT)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:L
Last Name:BELLOIR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 S GRAND BLVD STE 102S
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2272
Mailing Address - Country:US
Mailing Address - Phone:509-624-4200
Mailing Address - Fax:509-624-2817
Practice Address - Street 1:9725 W SUNSET HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-9426
Practice Address - Country:US
Practice Address - Phone:509-624-4100
Practice Address - Fax:509-624-2297
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist