Provider Demographics
NPI:1316282270
Name:BELAKOVSKIY, ABBEY K (DPT)
Entity type:Individual
Prefix:MRS
First Name:ABBEY
Middle Name:K
Last Name:BELAKOVSKIY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ABBEY
Other - Middle Name:K
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PROBILITY PHYSICAL THERAPY
Mailing Address - Street 2:2058 STATE STREET
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104
Mailing Address - Country:US
Mailing Address - Phone:734-913-0300
Mailing Address - Fax:734-913-0400
Practice Address - Street 1:PROBILITY PHYSICAL THERAPY
Practice Address - Street 2:2058 STATE STREET
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104
Practice Address - Country:US
Practice Address - Phone:734-913-0300
Practice Address - Fax:734-913-0400
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204585015Medicare PIN