Provider Demographics
NPI:1881921989
Name:JOEL N. BASLOT PT, LLC
Entity type:Organization
Organization Name:JOEL N. BASLOT PT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BASLOT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:843-423-4888
Mailing Address - Street 1:1021 CHERAW ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-2422
Mailing Address - Country:US
Mailing Address - Phone:843-423-4888
Mailing Address - Fax:843-423-4849
Practice Address - Street 1:2236 E HIGHWAY 76
Practice Address - Street 2:SUITE A
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571-6353
Practice Address - Country:US
Practice Address - Phone:843-423-4888
Practice Address - Fax:843-423-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty