Provider Demographics
NPI:1902097462
Name:BELLAVIA, RHONDA MARIE (PT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:MARIE
Last Name:BELLAVIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 PARKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1487
Mailing Address - Country:US
Mailing Address - Phone:303-717-0148
Mailing Address - Fax:
Practice Address - Street 1:502 PARKVIEW CT
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-1487
Practice Address - Country:US
Practice Address - Phone:303-717-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7537174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist