Provider Demographics
NPI:1508036252
Name:BASLER CHIROPRACTIC & WELLNESS
Entity Type:Organization
Organization Name:BASLER CHIROPRACTIC & WELLNESS
Other - Org Name:INFINITY ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BASLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-393-8228
Mailing Address - Street 1:8705 PROFESSIONAL PL
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4411
Mailing Address - Country:US
Mailing Address - Phone:703-393-8228
Mailing Address - Fax:703-393-9558
Practice Address - Street 1:8705 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4411
Practice Address - Country:US
Practice Address - Phone:703-393-8228
Practice Address - Fax:703-393-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002097111N00000X
VA0104001920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C06019Medicare PIN