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Lyle Douglas Basham JR., LMT
Specialist in Tampa, Florida
NPI 1487827846

Lyle Douglas Basham JR. is a Specialist based in Tampa, FL. Lyle Douglas Basham JR. practices in Tampa, FL and has the professional credentials of LMT. The NPI Number for Lyle Douglas Basham JR. is 1487827846 and holds a License No. MA52948 (Florida).

The current practice location address for Lyle Douglas Basham JR. is 12284 Country White Cir, Tampa, FL and can be reached out via phone at 813-395-3175.

Location: 12284 Country White Cir, Tampa, FL, 33635-6279
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487827846
Provider Name
Lyle Douglas Basham JR.
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
12284 Country White Cir, Tampa, FL, 33635-6279
Phone Number
813-395-3175
Fax Number
Provider Enumeration Date
04/08/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12284 Country White Cir
City
Tampa
State
Florida
Zip
33635-6279
Phone Number
813-395-3175
Fax Number
person
Provider Business Mailing Address Details
Address
12284 Country White Cir
City
Tampa
State
Florida
Zip
33635-6279
Phone Number
813-395-3175
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MA52948 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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