Provider Demographics
NPI:1972944213
Name:BASCO, CATHERINE C (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:C
Last Name:BASCO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:717-839-2125
Mailing Address - Fax:717-565-1104
Practice Address - Street 1:1404 E AVALON AVE STE B2
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1771
Practice Address - Country:US
Practice Address - Phone:256-978-4001
Practice Address - Fax:256-978-4002
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist