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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BLAKELYNN COLCLASURE BASS, DPT

Active Sole Proprietor

BLAKELYNN COLCLASURE BASS, DPT is a Physical Therapy Assistant healthcare provider located in VIDALIA, Louisiana. NPI 1629693601 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · VIDALIA, LA

Registration Details

NPI Number
1629693601
Provider Type
Individual
Gender
Female
NPI Issued
Jun 15, 2020 (6.1253020884477 yrs)
Last Updated
Jan 31, 2024
Licenses
10613 (LA)
10613 (LA)
Sole Proprietor
Yes

Practice Information

Address
4616 HIGHWAY 84 W
VIDALIA, LA, 713733357
Browse LA providers · Browse ZIP 71373
Phone
3183365400
Fax
3183368622
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in VIDALIA, LA

Name Credential NPI
MICHAEL R WIMBERLY II PT,MPT 1700937950
ERIN FOURNET WOODRUFF DPT 1053766410
MRS. LACEY OZBURN DPT 1043719040
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.