Healthcare Provider Details

I. General information

NPI: 1457263048
Provider Name (Legal Business Name): REGINALD BELLANGER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 OPELOUSAS AVE
NEW ORLEANS LA
70114-4343
US

IV. Provider business mailing address

4532 FELICIANA DR
NEW ORLEANS LA
70126-4702
US

V. Phone/Fax

Practice location:
  • Phone: 504-616-1778
  • Fax:
Mailing address:
  • Phone: 504-408-4349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA9982
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: