NICOLE BASHAM

STOCKTON, CA
NPI1245661164
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  41238)
Additional Taxonomies225100000X Physical Therapist
(Licence: WA  PT60408454)
Enumeration Date2013-12-03
Last Update Date2022-07-21
Business Address
-- NICOLE BASHAM DPT
10200 TRINITY PKWY STE 205
STOCKTON, CA 95219-7288
Phone number: 209-451-3920
Mailing Address
-- NICOLE BASHAM DPT
8557 DIAMOND OAK WAY
ELK GROVE, CA 95624-1749
Phone number: 858-735-1753