Individual
MR. CHARLES MATTHEW BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
4421 W MAIN ST, MIDLAND, MI 48640-2304
(989) 832-9026
Mailing address
1742 W BROOKS RD, BRECKENRIDGE, MI 48615-9646
(989) 615-6367
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005046
MI
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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