Provider Demographics
NPI:1861684177
Name:BELANGER, MICHAEL JAMES (PT, ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:BELANGER
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 LEONARD ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2939
Mailing Address - Country:US
Mailing Address - Phone:508-543-5217
Mailing Address - Fax:
Practice Address - Street 1:56 LEONARD ST
Practice Address - Street 2:SUITE 6
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2939
Practice Address - Country:US
Practice Address - Phone:508-543-5217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133062251S0007X
MA11672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer