Provider Demographics
NPI:1639138241
Name:BELANGER, RAY GENE (ATC)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:GENE
Last Name:BELANGER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 FRAWLEY RD
Mailing Address - Street 2:APARTMENT 815
Mailing Address - City:EAST RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37412-4075
Mailing Address - Country:US
Mailing Address - Phone:423-304-7953
Mailing Address - Fax:
Practice Address - Street 1:728 FRAWLEY RD
Practice Address - Street 2:APARTMENT 815
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-4075
Practice Address - Country:US
Practice Address - Phone:423-304-7953
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer