Provider Demographics
NPI:1053434944
Name:BELDING, CLINTON CARMEN (PT)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:CARMEN
Last Name:BELDING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 N MCCARRAN BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3878
Mailing Address - Country:US
Mailing Address - Phone:775-356-8484
Mailing Address - Fax:775-356-8488
Practice Address - Street 1:1311 N MCCARRAN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3878
Practice Address - Country:US
Practice Address - Phone:775-356-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV104515Medicare PIN