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Individual

MR. JOFFREE J. BASILISCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1023 W MAIN ST, VEVAY, IN 47043-9192
(812) 427-2803
Mailing address
10 S 9TH ST, STE 4, NOBLESVILLE, IN 46060-2631
(765) 524-3946
(317) 708-6496

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
003680
KY
225100000X
Physical Therapist
Primary
05007999A
IN

Other

Enumeration date
07/03/2007
Last updated
10/27/2020
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