Katelyn M Basden, DPT | |
315 Burton Rd Ste 107, New London, WI 54961-1176 | |
(920) 982-3670 | |
Not Available |
Full Name | Katelyn M Basden |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 315 Burton Rd Ste 107, New London, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326809146 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 16477 (Wisconsin) | Primary |
Provider Name | Orthopedic & Spine Therapy Of New London Sc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1437187135 PECOS PAC ID: 6901869411 Enrollment ID: O20041105000588 |
Mailing Address | Practice Location Address |
---|---|
Katelyn M Basden, DPT 1000 Midway Rd, Menasha, WI 54952-1116 Ph: () - | Katelyn M Basden, DPT 315 Burton Rd Ste 107, New London, WI 54961-1176 Ph: (920) 982-3670 |
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