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Individual

MR. RAYMOND A BELISLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
5132 BEATLINE RD, SUITE D, LONG BEACH, MS 39560-3869
(228) 575-8429
(228) 575-8891
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(228) 388-5714
(228) 388-0017

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
06525R
LA
225100000X
Physical Therapist
Primary
PT4978
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015077
MS
01
1033218524
GROUP NPI
MS
Enumeration date
05/11/2006
Last updated
01/11/2012
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