Provider Demographics
NPI:1437678422
Name:BELLE, JUSTIN ROBERT (AT, ATC)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:ROBERT
Last Name:BELLE
Suffix:
Gender:M
Credentials:AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14161 ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9195
Mailing Address - Country:US
Mailing Address - Phone:440-488-5038
Mailing Address - Fax:
Practice Address - Street 1:14161 ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9195
Practice Address - Country:US
Practice Address - Phone:440-488-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
OHAT0058402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer