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Individual

ANNE M BASDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT, CSCS, MLD/CDP

Contact information

Practice address
7300 E INDIANA ST, STE. 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Mailing address
7300 E INDIANA ST, STE. 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
005547
KY
225100000X
Physical Therapist
Primary
05003858A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000212737
BLUE CROSS BLUE SHIELD
IN
05
200839710
IN
Enumeration date
12/02/2005
Last updated
11/24/2010
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