Healthcare Provider Details

I. General information

NPI: 1235519281
Provider Name (Legal Business Name): BRADLEY ANTHONY BASCH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 DUNWELL AVE
ASHEVILLE NC
28806-3411
US

IV. Provider business mailing address

146 DUNWELL AVE
ASHEVILLE NC
28806-3411
US

V. Phone/Fax

Practice location:
  • Phone: 407-539-4342
  • Fax:
Mailing address:
  • Phone: 407-539-4342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP15607
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberP15607
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: