Provider Demographics
NPI:1619204872
Name:BASSETT, CHERYL A (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:BASSETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:A
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2304 S ELDRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4828
Mailing Address - Country:US
Mailing Address - Phone:303-980-5011
Mailing Address - Fax:303-986-1878
Practice Address - Street 1:2304 S ELDRIDGE CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4828
Practice Address - Country:US
Practice Address - Phone:303-980-5011
Practice Address - Fax:303-986-1878
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1248225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics