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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629693601 NPPES
Louisiana MEDICAID 2532499

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