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Individual

MICHAEL BASSETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 878-5021
(219) 878-5002
Mailing address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 878-5021
(219) 878-5002

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001829A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100163030
IN
Enumeration date
01/25/2006
Last updated
08/08/2011
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