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1619105020
JOSHUA O BELLAVANCE
SOUTH BURLINGTON, VT
NPI
1619105020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VT 104-0000177)
Enumeration Date
2009-06-24
Last Update Date
2011-12-14
Business Address
Mr. JOSHUA O BELLAVANCE MS, ATC, LAT
185 TILLEY DR
SOUTH BURLINGTON, VT 05403-4484
Phone number: 802-879-1703
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Mailing Address
Mr. JOSHUA O BELLAVANCE MS, ATC, LAT
86 PINECREST DR UNIT 10B
ESSEX JUNCTION, VT 05452-4405
Phone number:
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