Provider Demographics
NPI:1083129225
Name:BASLER, LUKE JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:JOSEPH
Last Name:BASLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-1872
Mailing Address - Country:US
Mailing Address - Phone:401-421-0290
Mailing Address - Fax:
Practice Address - Street 1:1261 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-1872
Practice Address - Country:US
Practice Address - Phone:401-421-0290
Practice Address - Fax:401-421-0293
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2092111N00000X
RI00668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor