Individual
KELLY CORINNE BASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
444 S 44TH ST, OMAHA, NE 68131-3727
(402) 559-6415
(402) 559-9263
Mailing address
985450 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5450
(402) 559-6415
(402) 559-9263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3033
NE
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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