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Individual
SALLY COLLMANN BASS
Active
Individual
SALLY COLLMANN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202009048
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202009048
PHARMACIST LICENSE
VA
Enumeration date
01/19/2021
Last updated
01/19/2021
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