Provider Demographics
NPI:1285034777
Name:BASSETT, DARCY SUZANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:SUZANNE
Last Name:BASSETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:SUZANNE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-8907
Mailing Address - Fax:423-954-7408
Practice Address - Street 1:277 HIGHWAY 74 N
Practice Address - Street 2:STE 203
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1569
Practice Address - Country:US
Practice Address - Phone:678-364-0037
Practice Address - Fax:678-364-0858
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist