Camille Basham

Individual provider Active NPI Physical Therapist · Shelbyville, KY

NPI 1891249397 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1891249397
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
006906 (KY)
Practice address
90 Howard Dr
Shelbyville, KY 40065-8138
Phone
(502) 633-1007
Fax
(502) 805-1511
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
006906KYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006906 KY Yes

Addresses

Primary practice location

90 Howard Dr
Shelbyville, KY 40065-8138

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

Other names

  • Camille Pfetzer Former name

Other providers in Shelbyville, KY

All providers in Shelbyville, KY · Physical Therapist in Kentucky

Sources for this page

Verify at the official NPI Registry.