Individual
SHANNON BASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1784 RIDGE RD., ONTARIO, NY 14519-0155
(315) 524-1138
Mailing address
PO BOX 155, ONTARIO, NY 14519-0155
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
631285-1
NY
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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