Provider Demographics
NPI:1982817656
Name:BASSLER, FLOYD JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:FLOYD
Middle Name:JOSEPH
Last Name:BASSLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 PAINT ROCK FERRY RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-5150
Mailing Address - Country:US
Mailing Address - Phone:865-376-7938
Mailing Address - Fax:865-717-0182
Practice Address - Street 1:306 HOMEPARK RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4434
Practice Address - Country:US
Practice Address - Phone:865-717-0182
Practice Address - Fax:865-717-0182
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4130415OtherBLUECROSS BLUESHIELD