Individual
MR. JOEL ANDREW BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS ATC
Contact information
Practice address
WEBER STATE UNIVERSITY, 2701 UNIVERSITY CIRCLE, OGDEN, UT 84408-0001
(801) 626-6501
(801) 626-7264
Mailing address
2025 E. SKYLINE DRIVE, SOUTH OGDEN, UT 84403
(801) 475-5449
(801) 626-7264
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6346129-4810
LICENSE, ATHLETIC TRAINER
UT
Enumeration date
02/28/2006
Last updated
07/08/2007
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