Provider Demographics
NPI:1700976263
Name:BELANGER, LEE PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:PATRICK
Last Name:BELANGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 SPRING VALLEY STREET
Mailing Address - Street 2:PO BOX 733
Mailing Address - City:BEULAH
Mailing Address - State:MI
Mailing Address - Zip Code:49617-0733
Mailing Address - Country:US
Mailing Address - Phone:231-882-7000
Mailing Address - Fax:231-882-7000
Practice Address - Street 1:453 SPRING VALLEY STREET
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:MI
Practice Address - Zip Code:49617-0733
Practice Address - Country:US
Practice Address - Phone:231-882-7000
Practice Address - Fax:231-882-7000
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILB006833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor