Individual
DR. STACEY BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
734 N GREENWOOD AVE, WARE SHOALS, SC 29692-1233
(864) 456-7512
(864) 456-2858
Mailing address
734 N GREENWOOD AVE, WARE SHOALS, SC 29692-1233
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12208
SC
Other
Enumeration date
09/18/2010
Last updated
09/18/2010
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