Individual
CHRISTOPHER BASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17342 CAMILLIA TRL, CONROE, TX 77302-2706
(936) 662-2244
Mailing address
17342 CAMILLIA TRL, CONROE, TX 77302-2706
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
1293219
TX
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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