Provider Demographics
NPI:1538202882
Name:BELICE, ANDREW JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:BELICE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2532
Mailing Address - Country:US
Mailing Address - Phone:406-683-9600
Mailing Address - Fax:406-683-9700
Practice Address - Street 1:330 S IDAHO ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2532
Practice Address - Country:US
Practice Address - Phone:406-683-9600
Practice Address - Fax:406-683-9700
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0162928Medicaid
MT0162945Medicaid
350054899OtherRAILROAD MEDICARE
41921OtherBLUE CROSS BLUE SHIELD
MT0162945Medicaid
MT0162928Medicaid