Provider Demographics
NPI:1861382434
Name:BASCOM, RICKIE (MPT)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:
Last Name:BASCOM
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 N FATTIG CREEK RD
Mailing Address - Street 2:BASCOM4EVER@MSN.COM
Mailing Address - City:ROUNDUP
Mailing Address - State:MT
Mailing Address - Zip Code:59072
Mailing Address - Country:US
Mailing Address - Phone:801-668-4828
Mailing Address - Fax:
Practice Address - Street 1:1807 24TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2850
Practice Address - Country:US
Practice Address - Phone:406-656-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT273142251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics