Provider Demographics
NPI:1679859227
Name:BELLSKY, DAWN (PT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BELLSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2936
Mailing Address - Country:US
Mailing Address - Phone:989-550-2436
Mailing Address - Fax:
Practice Address - Street 1:111 SEWELL STREET 146 STATE HOUSE STATION
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04333-7518
Practice Address - Country:US
Practice Address - Phone:207-624-6660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MEPT4359225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ654883Medicaid