Provider Demographics
NPI:1932239423
Name:BASLER CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:BASLER CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:BASLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-421-9695
Mailing Address - Street 1:909 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5752
Mailing Address - Country:US
Mailing Address - Phone:401-421-9695
Mailing Address - Fax:401-331-1550
Practice Address - Street 1:909 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5752
Practice Address - Country:US
Practice Address - Phone:401-421-9695
Practice Address - Fax:401-331-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
204246OtherBLUE CHIP
3542-2OtherBLUE CROSS & BLUE SHIELD
204246OtherBLUE CHIP