Individual
PRITI J BASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4102 WOOLWORTH AVE, OMAHA, NE 68105-1851
(402) 444-7450
Mailing address
9212 CALIFORNIA PLZ APT 103, OMAHA, NE 68114-2631
(317) 544-8656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3163
NE
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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