Provider Demographics
NPI:1639767437
Name:SUTTON, BASEEMA (LMT)
Entity type:Individual
Prefix:
First Name:BASEEMA
Middle Name:
Last Name:SUTTON
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2347 OREGON PIKE SUITE 107
Mailing Address - Street 2:ATTN: PMB #231 SW WELLNESS & MASSAGE
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5182
Mailing Address - Country:US
Mailing Address - Phone:717-655-3301
Mailing Address - Fax:
Practice Address - Street 1:2064 FRUITVILLE PIKE STE 113
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-7200
Practice Address - Country:US
Practice Address - Phone:717-655-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG013389225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist