Provider Demographics
NPI:1184756918
Name:BELKEN, MICHELLE T (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:T
Last Name:BELKEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:K
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1913 TETON AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-9523
Mailing Address - Country:US
Mailing Address - Phone:419-873-8556
Mailing Address - Fax:
Practice Address - Street 1:5440 CORPORATE DR STE 400
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2645
Practice Address - Country:US
Practice Address - Phone:866-902-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0604353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2746452Medicaid
OH4203682Medicare PIN