Provider Demographics
NPI:1255542445
Name:BELCHER, DEBRA LYNNE (PT,ATC,SCS)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNNE
Last Name:BELCHER
Suffix:
Gender:F
Credentials:PT,ATC,SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CHARTER OAK CT
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1527
Mailing Address - Country:US
Mailing Address - Phone:401-398-7188
Mailing Address - Fax:
Practice Address - Street 1:235 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02912-9090
Practice Address - Country:US
Practice Address - Phone:401-863-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT007042251S0007X
RIAT001022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer