Individual
BLAKELYNN COLCLASURE BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10613
LA
261QP2000X
Physical Therapy Clinic/Center
10613
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2532499
—
LA
Enumeration date
06/15/2020
Last updated
01/31/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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