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General NPI Number Information
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NPI Number | 1326098252
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Entity Type | Individual
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Provider Name | RAYMOND A BELISLE MSPT
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 5132 BEATLINE RD SUITE D
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City | LONG BEACH
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State | MS
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Zip | 39560-3869
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Country | US
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Telephone | 228-575-8429
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Fax | 228-575-8891
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Provider Business Mailing Address
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Address Line | PO BOX 8419
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City | BILOXI
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State | MS
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Zip | 39535-8087
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Country | US
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Telephone | 228-388-5714
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Fax | 228-388-0017
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 06525R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT4978
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License Number State | MS
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