Provider Demographics
NPI:1235877291
Name:BASLER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BASLER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BASLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-852-3747
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty