Provider Demographics
NPI:1578645040
Name:BASLER, KATHY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:LYNN
Last Name:BASLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:694 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3500
Mailing Address - Country:US
Mailing Address - Phone:401-885-0260
Mailing Address - Fax:401-885-6266
Practice Address - Street 1:694 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3500
Practice Address - Country:US
Practice Address - Phone:401-885-0260
Practice Address - Fax:401-885-6266
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU29684Medicare UPIN
RI007058980Medicare PIN