Provider Demographics
NPI:1578507646
Name:BASSION, KENNETH II (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:BASSION
Suffix:II
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 1:939 HORSHAM RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-9610
Mailing Address - Country:US
Mailing Address - Phone:215-368-3331
Mailing Address - Fax:215-362-9117
Practice Address - Street 1:939 HORSHAM ROAD
Practice Address - Street 2:
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9610
Practice Address - Country:US
Practice Address - Phone:215-368-3331
Practice Address - Fax:215-362-9117
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002898L111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000196383OtherHIGHMARK / AMERIHEALTH
PA0091774000OtherINDEPENDENCE BLUE SHIELD
PA087684Medicare PIN