Provider Demographics
NPI:1477677649
Name:BASINGER, DANNY MARION (PTA)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:MARION
Last Name:BASINGER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 SKYLINE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143
Mailing Address - Country:US
Mailing Address - Phone:501-268-5008
Mailing Address - Fax:501-268-5025
Practice Address - Street 1:954 SKYLINE
Practice Address - Street 2:SUITE 100
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143
Practice Address - Country:US
Practice Address - Phone:501-268-5008
Practice Address - Fax:501-268-5025
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA1522225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant