Bass, Blakelynn Colclasure
Bass, Blakelynn Colclasure is an sole proprietor health care provider with primary practice located at 4616 Highway 84 W , Vidalia LA 71373-3357. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Physical Therapy, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Bass, Blakelynn Colclasure can be contacted via phone (318) 336-5400.Contact Information
Primary practice address
4616 Highway 84 W
Vidalia LA 71373-3357
Phone: (318) 336-5400
Fax: (318) 336-8622
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Physical Therapy | 261QP2000X | 10613 | Louisiana |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 10613 | Louisiana |
Profile Details
| NPI number | 1629693601 |
|---|---|
| LBN Legal business name | Bass, Blakelynn Colclasure |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2020 |
| Last updated | Jan 31st, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629693601 | NPPES |
| Louisiana | MEDICAID | 2532499 |
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