Provider Demographics
NPI:1992880389
Name:BASLER, LISA BOCHYNSKI (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:BOCHYNSKI
Last Name:BASLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8705 PROFESSIONAL PL
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4411
Mailing Address - Country:US
Mailing Address - Phone:703-393-8228
Mailing Address - Fax:703-393-9558
Practice Address - Street 1:8705 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4411
Practice Address - Country:US
Practice Address - Phone:703-393-8228
Practice Address - Fax:703-393-9558
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA336611OtherANTHEM
VAG6430002OtherCAREFIRST
VA1030999OtherASH