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Contact Information

BLAKELYNN C BASS, DPT
4616 HIGHWAY 84 W
VIDALIA, LA71373-3357
 Phone: 318-336-5400
 Fax: 318-336-8622
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for BLAKELYNN C BASS · (Female)

NPI Number 1629693601
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 06/15/2020
Last updated 01/31/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 10613
  • LA Medicaid 2532499
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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