Healthcare Provider Details

I. General information

NPI: 1336065234
Provider Name (Legal Business Name): DONNA MARIE BELLEROSE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 FRONTAGE RD
MANCHESTER NH
03103-6013
US

IV. Provider business mailing address

62 N ADAMS ST
MANCHESTER NH
03104-2533
US

V. Phone/Fax

Practice location:
  • Phone: 978-606-7402
  • Fax:
Mailing address:
  • Phone: 978-606-7402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8177
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: