Individual
VICKI BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
531 THISTLE CIR, MARTINEZ, CA 94553-5816
(925) 228-2143
Mailing address
531 THISTLE CIR, MARTINEZ, CA 94553-5816
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3317
CA
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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