Healthcare Provider Details

I. General information

NPI: 1699794099
Provider Name (Legal Business Name): MRS. ASHLEY MICHELLE BELT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 N CLARKSON ST SUITE 2
FREMONT NE
68025-7716
US

IV. Provider business mailing address

2403 S 133RD PLZ
OMAHA NE
68144-5905
US

V. Phone/Fax

Practice location:
  • Phone: 402-721-0235
  • Fax: 402-721-6167
Mailing address:
  • Phone: 402-330-8433
  • Fax: 402-330-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2472
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: