Doctor Name: | MR. JOFFREE J. BASILISCO |
NPI Number: | 1730386640 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 003680 |
Business Practice Address: | 1023 W Main St Vevay, IN - 470439192 |
Business Phone Number: | 8124272803 |
Business Fax Number: | |
Mailing Address: | 302 Woodfill Ave, VEVAY |
State: | IN |
Postal Code: | 470432684 |
Phone Number: | 5025422054 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 003680 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |