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Individual

DANIEL BASTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2600 S ROCK CREEK PKWY APT 21-101, SUPERIOR, CO 80027-4505
(303) 919-2324
Mailing address
566 S MCCASLIN BLVD UNIT 270316, SUPERIOR, CO 80027-5249
(347) 489-4533

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0015879
CO
225100000X
Physical Therapist
030617-1
NY
225100000X
Physical Therapist
PT27724
FL

Other

Enumeration date
04/20/2009
Last updated
03/22/2021
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