Provider Demographics
NPI:1689019846
Name:BELCHAK, JAMIE S (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:S
Last Name:BELCHAK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ALBERT CREE DRIVE
Mailing Address - Street 2:PO BOX 787
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05702-0787
Mailing Address - Country:US
Mailing Address - Phone:802-775-0568
Mailing Address - Fax:802-773-2304
Practice Address - Street 1:3 GENERAL WING RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4758
Practice Address - Country:US
Practice Address - Phone:802-775-0568
Practice Address - Fax:802-775-2304
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist