Healthcare Provider Details

I. General information

NPI: 1851631972
Provider Name (Legal Business Name): KAYE BASEDOW RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER, UNIT 33100
APO ARMED FORCES EUROPE
09180
DE

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER, UNIT 33100
APO ARMED FORCES EUROPE
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 314-590-7986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1625
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: