Provider Demographics
NPI:1578594800
Name:BELVILLE, AMY (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BELVILLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3107 FREDRICK AVE , STE B
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506
Mailing Address - Country:US
Mailing Address - Phone:816-233-9888
Mailing Address - Fax:816-233-0414
Practice Address - Street 1:3107 FREDRICK AVE , STE B
Practice Address - Street 2:SUITE 250
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506
Practice Address - Country:US
Practice Address - Phone:816-233-9888
Practice Address - Fax:816-233-0414
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2003013938204R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation